MEDICARE: TABATHA HOWARD LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant
2	225700000X	Massage Therapist	12745	TN

General Provider Information

NPI Number	:	1538667159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABATHA HOWARD LMT

Provider Business Mailing Address
First Line	:	600 HOLLANDALE RD
Second Line	:
City	:	LA VERGNE
State	:	TN
Zip	:	37086
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 ENON SPRINGS RD E
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-4442
Country	:	US
Telephone Number	:	615-625-5061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2018
Last Update Date	:	05/18/2020

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Directions to “ TABATHA HOWARD LMT” Practice Location

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