Provider Demographics
NPI:1114109154
Name:TOMS, KELLEY KOLINSKY (DOM, LAC, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:KOLINSKY
Last Name:TOMS
Suffix:
Gender:F
Credentials:DOM, LAC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14602 BRENTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2014
Mailing Address - Country:US
Mailing Address - Phone:813-334-9108
Mailing Address - Fax:
Practice Address - Street 1:14602 BRENTWOOD PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2014
Practice Address - Country:US
Practice Address - Phone:813-334-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2478171100000X
NC460171100000X
FLOT 9087225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist