Individual provider · Type 1 NPI

Lamont Joseph Jack, PTA

Physical Therapy Assistant · Tucker, GA

NPI number 1154979193 Active

Practice location

3888 Lavista Rd
Tucker, GA 30084-5142

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XPTA002207 (GA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1154979193

Lamont Joseph Jack, PTA's National Provider Identifier is 1154979193, issued on Sep 3, 2019. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Tucker, GA. The record was last updated on Sep 3, 2019.