Provider Demographics
NPI:1194353714
Name:ADKINS, TAYLOR (PTA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 TWIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:TN
Mailing Address - Zip Code:37726-3304
Mailing Address - Country:US
Mailing Address - Phone:931-267-1725
Mailing Address - Fax:
Practice Address - Street 1:2665 LAWNVILLE RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-4303
Practice Address - Country:US
Practice Address - Phone:865-394-0563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6683225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty