Provider Demographics
NPI:1760687172
Name:TOMPKINS, RONALD LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:LYNN
Last Name:TOMPKINS
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 1:518 B ST
Mailing Address - Street 2:
Mailing Address - City:SMITH CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:66967-1713
Mailing Address - Country:US
Mailing Address - Phone:785-282-0735
Mailing Address - Fax:
Practice Address - Street 1:518 B ST
Practice Address - Street 2:
Practice Address - City:SMITH CENTER
Practice Address - State:KS
Practice Address - Zip Code:66967-1713
Practice Address - Country:US
Practice Address - Phone:785-282-0735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00476225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant