Provider Demographics
NPI:1215158845
Name:LEHMAN, JUSTIN EUGENE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:EUGENE
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S. MAIN STREET
Mailing Address - Street 2:KING-HORN SPORTSCENTER
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810
Mailing Address - Country:US
Mailing Address - Phone:419-772-3923
Mailing Address - Fax:
Practice Address - Street 1:525 S. MAIN STREET
Practice Address - Street 2:KING-HORN SPORTSCENTER
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810
Practice Address - Country:US
Practice Address - Phone:419-772-3923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH22032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer