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Individual
MRS. TINA MARIE MCKINNEY
Active
Individual
MRS. TINA MARIE MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 08119
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340569
ANTHEM
OH
05
—
2506881
—
OH
01
—
P00287988
MEDICARE RAILROAD
OH
Enumeration date
07/13/2005
Last updated
09/01/2011
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