Healthcare Provider Details

I. General information

NPI: 1740583772
Provider Name (Legal Business Name): TAMMY LYNN KEFFAS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 RAND PL
FRANKLIN TN
37064-5531
US

IV. Provider business mailing address

220 GRANGER VIEW CIR
FRANKLIN TN
37064-2972
US

V. Phone/Fax

Practice location:
  • Phone: 615-423-9568
  • Fax:
Mailing address:
  • Phone: 615-595-4974
  • Fax: 615-595-4974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8485
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: