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General NPI Number Information
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NPI Number | 1235646746
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Entity Type | Individual
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Provider Name | LISA MARIE ADKINS ATC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 1 COLLEGE DR
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City | LIVINGSTON
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State | AL
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Zip | 35470-2098
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Country | US
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Telephone | 205-652-3872
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Fax |
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Provider Business Mailing Address
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Address Line | 309 COLONIAL DR
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City | BUTLER
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State | AL
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Zip | 36904-3534
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Country | US
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Telephone | 205-245-2366
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 2000030445
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License Number State | AL
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