Provider Demographics
NPI:1871507756
Name:TOMKINS, ANTHONY B (MSPT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:B
Last Name:TOMKINS
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N HIGHWAY 25
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-9388
Mailing Address - Country:US
Mailing Address - Phone:864-834-4995
Mailing Address - Fax:864-834-4551
Practice Address - Street 1:600 N HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690
Practice Address - Country:US
Practice Address - Phone:864-834-4995
Practice Address - Fax:864-834-4551
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2120OtherSC PT BOAD
SC9429OtherMEDICARE GROUP PTAN
SC2120OtherSC PT BOAD