Provider Demographics
NPI:1821340811
Name:AKINS, BETHANY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:AKINS
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 1:83 CAROL DR
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1166
Mailing Address - Country:US
Mailing Address - Phone:508-822-1154
Mailing Address - Fax:508-828-1004
Practice Address - Street 1:675 PARAMOUNT DR
Practice Address - Street 2:SUITE 103
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5416
Practice Address - Country:US
Practice Address - Phone:508-828-1011
Practice Address - Fax:508-828-1004
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist