Most Relevant Information
Provider Data
| NPI Number: | 1003041120 |
| Provider Name: | DANA LEE SLACK PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT8340 |
Most Important Dates
| Enumeration Date: | 05/19/2009 |
| Last Updated: | 05/19/2009 |
Provider Practice Location
102 DUNHILL PL NW STE B
CLEVELAND
TN
373113890
Practice Location Phone/Fax
| Phone: | 4235590444 |
| Fax: | 4235590103 |
Provider Mailing Location
8823 PRODUCTION LN
OOLTEWAH
TN
373636511
Provider Mailing Phone/Fax
| Phone: | 4232387217 |
| Fax: | 4232383473 |