Provider Demographics
NPI:1841538600
Name:ADKINS, TAMI LYN (LMT)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:LYN
Last Name:ADKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:LYN
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 E WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1822
Mailing Address - Country:US
Mailing Address - Phone:502-775-9834
Mailing Address - Fax:
Practice Address - Street 1:1100 MILTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1259
Practice Address - Country:US
Practice Address - Phone:502-637-7754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKOOKY-4443225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist