Provider Demographics
NPI:1982751905
Name:PERKINS, TISHA WINNINGHAM (PT)
Entity Type:Individual
Prefix:MS
First Name:TISHA
Middle Name:WINNINGHAM
Last Name:PERKINS
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 1:85 WHISPERING PINES CV
Mailing Address - Street 2:
Mailing Address - City:COUNCE
Mailing Address - State:TN
Mailing Address - Zip Code:38326-4313
Mailing Address - Country:US
Mailing Address - Phone:731-607-3230
Mailing Address - Fax:731-689-0689
Practice Address - Street 1:85 WHISPERING PINES CV
Practice Address - Street 2:
Practice Address - City:COUNCE
Practice Address - State:TN
Practice Address - Zip Code:38326-4313
Practice Address - Country:US
Practice Address - Phone:731-607-3230
Practice Address - Fax:731-689-0689
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist