Provider Demographics
NPI:1013159375
Name:TURNER, TINA M (LMT)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:M
Last Name:TURNER
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:PO BOX 9514
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-0514
Mailing Address - Country:US
Mailing Address - Phone:304-690-6784
Mailing Address - Fax:
Practice Address - Street 1:5505 US ROUTE 60 STE 155
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2070
Practice Address - Country:US
Practice Address - Phone:304-690-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2008-2524225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist