Provider Demographics
NPI:1760471874
Name:SPINKS, TOMMY H (ATC/LAT)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:H
Last Name:SPINKS
Suffix:
Gender:M
Credentials:ATC/LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E DOYLE ST
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-2007
Mailing Address - Country:US
Mailing Address - Phone:706-282-1414
Mailing Address - Fax:706-886-3150
Practice Address - Street 1:800 E DOYLE ST
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-2007
Practice Address - Country:US
Practice Address - Phone:706-282-1414
Practice Address - Fax:706-886-3150
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0002452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer