Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samson O Lanade Jr., PTA

Individual provider Physical Therapy Assistant · NPI 1871242628

Samson O Lanade Jr., PTA is a Physical Therapy Assistant in Jackson, Tennessee. Licensed in Tennessee. Registered with an NPI since 2022.

Licensed in
TN
In the registry since
2022
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

587 Skyline Dr
Jackson, TN 38301-3938
Phone: (731) 421-6510
Fax: (731) 421-6515
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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 7502 (TN)

Record details

NPI number1871242628
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedMarch 21, 2022
Last updated in NPPESMarch 21, 2022
Certification dateMarch 21, 2022
Mailing address1804 Highway 45 Byp Ste 604, Jackson, TN 38305-4403

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