MEDICARE: JACOB LOHR DPT

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	13186	TN

General Provider Information

NPI Number	:	1528674686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB LOHR DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7568
Fax Number	:

Provider Business Practice Location Address
First Line	:	7688 OAK RIDGE HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37931-3335
Country	:	US
Telephone Number	:	865-313-2865
Fax Number	:	865-313-2899

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

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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