Provider Demographics
NPI:1649098658
Name:ATCHENSON, TINA L (LMT)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:L
Last Name:ATCHENSON
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 1:623 COUNTY ROAD 61
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35634-2562
Mailing Address - Country:US
Mailing Address - Phone:256-349-2144
Mailing Address - Fax:
Practice Address - Street 1:623 COUNTY ROAD 61
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35634-2562
Practice Address - Country:US
Practice Address - Phone:256-349-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6450225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist