Provider Demographics
NPI:1639106255
Name:SKRINE, TIEKA ZAKIE (ATC)
Entity Type:Individual
Prefix:MS
First Name:TIEKA
Middle Name:ZAKIE
Last Name:SKRINE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 RABBIT RIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-4371
Mailing Address - Country:US
Mailing Address - Phone:229-460-2268
Mailing Address - Fax:
Practice Address - Street 1:2813 RABBIT RIDGE RUN
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-4371
Practice Address - Country:US
Practice Address - Phone:229-460-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0012152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer