Provider Demographics
NPI:1538127030
Name:TUMINELLO, JAMES T (PTA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:T
Last Name:TUMINELLO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 924
Mailing Address - Street 2:
Mailing Address - City:BAY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39422
Mailing Address - Country:US
Mailing Address - Phone:601-764-4125
Mailing Address - Fax:601-764-3930
Practice Address - Street 1:14 N 3RD ST STE B
Practice Address - Street 2:
Practice Address - City:BAY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39422
Practice Address - Country:US
Practice Address - Phone:601-764-4125
Practice Address - Fax:601-764-3930
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPA1654225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant