Provider Demographics
NPI:1639205750
Name:ADAMS, REBECCA TOMPKINS (LMT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:TOMPKINS
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SE JEREMY PL
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-3903
Mailing Address - Country:US
Mailing Address - Phone:386-288-6642
Mailing Address - Fax:
Practice Address - Street 1:4134 W US HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4874
Practice Address - Country:US
Practice Address - Phone:386-752-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist