Provider Demographics
NPI:1457489254
Name:TINKEY, DANIEL KENT (ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:KENT
Last Name:TINKEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 LINCOLN PINES PL
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9106
Mailing Address - Country:US
Mailing Address - Phone:269-429-7718
Mailing Address - Fax:
Practice Address - Street 1:3950 HOLLYWOOD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9151
Practice Address - Country:US
Practice Address - Phone:269-556-7150
Practice Address - Fax:269-556-7151
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer