MEDICARE: LISA A. HATFIELD PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT1477	TN

General Provider Information

NPI Number	:	1386061794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A. HATFIELD PT

Provider Business Mailing Address
First Line	:	2110 N JACKSON ST
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2208
Country	:	US
Telephone Number	:	931-455-5189
Fax Number	:	931-393-2455

Provider Business Practice Location Address
First Line	:	2110 N JACKSON ST
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2208
Country	:	US
Telephone Number	:	931-455-5189
Fax Number	:	931-393-2455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	03/09/2026

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