Provider Demographics
NPI:1528332194
Name:BIETER, LONA CAROL (LMT)
Entity type:Individual
Prefix:
First Name:LONA
Middle Name:CAROL
Last Name:BIETER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 SIGNAL MOUNTAIN RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-1933
Mailing Address - Country:US
Mailing Address - Phone:423-605-4855
Mailing Address - Fax:
Practice Address - Street 1:243 SIGNAL MOUNTAIN RD
Practice Address - Street 2:SUITE E
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-1933
Practice Address - Country:US
Practice Address - Phone:423-605-4855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMT0000003452225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist