Basic Information
| Provider Information | |||||||||
| NPI: | 1780630624 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUMONT | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2919 BALL HOLLOW RD | ||||||||
| Address2: | |||||||||
| City: | PULASKI | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384786634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9314245769 | ||||||||
| FaxNumber: | 2563507757 | ||||||||
| Practice Location | |||||||||
| Address1: | 22270 US HIGHWAY 72 | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356132604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562321221 | ||||||||
| FaxNumber: | 2562321231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | PTH3233 | AL | Y | Other Service Providers | Specialist |
No ID Information.