Provider Demographics
NPI:1538832951
Name:EASTERLY, RHONDA JOYCE (LPTA)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:JOYCE
Last Name:EASTERLY
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SPRING ST APT I5
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-5451
Mailing Address - Country:US
Mailing Address - Phone:276-952-7141
Mailing Address - Fax:
Practice Address - Street 1:3840 TN-394
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-3761
Practice Address - Country:US
Practice Address - Phone:423-274-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant