Provider Demographics
NPI:1285613752
Name:WATKINS, TAMMY J (DC)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:J
Last Name:WATKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:J
Other - Last Name:WALZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2555 BERKSHIRE PKWY STE F
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-4646
Mailing Address - Country:US
Mailing Address - Phone:515-987-6332
Mailing Address - Fax:515-978-6455
Practice Address - Street 1:2555 BERKSHIRE PKWY STE F
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-4646
Practice Address - Country:US
Practice Address - Phone:515-987-6332
Practice Address - Fax:515-978-6455
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor