Provider Demographics
NPI:1063674604
Name:TUMLIN, DANA ANN (LMT, NMT)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ANN
Last Name:TUMLIN
Suffix:
Gender:F
Credentials:LMT, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BELLVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-4701
Mailing Address - Country:US
Mailing Address - Phone:423-368-3431
Mailing Address - Fax:
Practice Address - Street 1:300 BELLVIEW RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-4701
Practice Address - Country:US
Practice Address - Phone:423-368-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004768225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist