Provider Demographics
NPI:1497795850
Name:TOMBERLIN, TORY LYNNE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:TORY
Middle Name:LYNNE
Last Name:TOMBERLIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:2318 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-8704
Practice Address - Country:US
Practice Address - Phone:865-984-3141
Practice Address - Fax:865-984-3893
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPTOOOOOO7487OtherPHYSICAL THERAPY LICENSE