Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lamont Joseph Jack, PTA

Individual provider Physical Therapy Assistant · NPI 1154979193

Lamont Joseph Jack, PTA is a Physical Therapy Assistant in Tucker, Georgia. Licensed in Georgia. Registered with an NPI since 2019.

Licensed in
GA
In the registry since
2019
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

3888 Lavista Rd
Tucker, GA 30084-5142
Phone: (770) 938-5740
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA002207 (GA)

Record details

NPI number1154979193
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedSeptember 3, 2019
Last updated in NPPESSeptember 3, 2019
Mailing address3888 Lavista Rd, Tucker, GA 30084-5142

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