Provider Demographics
NPI:1891048138
Name:HUGHES, TINA GAY (MSPT)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:GAY
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 BUCKS BR
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:KY
Mailing Address - Zip Code:41649-7805
Mailing Address - Country:US
Mailing Address - Phone:606-939-0656
Mailing Address - Fax:606-285-2609
Practice Address - Street 1:1283 BUCKS BR
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:KY
Practice Address - Zip Code:41649-7805
Practice Address - Country:US
Practice Address - Phone:606-939-0656
Practice Address - Fax:606-285-2609
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist