Doctor Name: | TAMALA BLEVINS |
NPI Number: | 1053486811 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT007951 |
Business Practice Address: | 4041 Smithfield Trl Ellenwood, GA - 302941655 |
Business Phone Number: | 4045202675 |
Business Fax Number: | |
Mailing Address: | 4041 Smithfield Trl, ELLENWOOD |
State: | GA |
Postal Code: | 302941655 |
Phone Number: | 4045202675 |
Fax Number: | |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 06/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT007951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |