Provider Demographics
NPI:1578778122
Name:KENT, TAMARA A (PT)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:A
Last Name:KENT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8267 SPOON CV
Mailing Address - Street 2:APT 303
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-4129
Mailing Address - Country:US
Mailing Address - Phone:901-481-7695
Mailing Address - Fax:
Practice Address - Street 1:326 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-5577
Practice Address - Country:US
Practice Address - Phone:731-221-2478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist