Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2000030445 | AL |
Y | 213ES0000X | Sports Medicine | 2000030445 | AL |
NPI | 1235646746 |
---|---|
Provider Name | Lisa Marie Adkins |
First Address | Butler, AL 36904-3534 |
Second Address | Livingston, AL 35470-2098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2018 |
Last Update Date | 05/01/2018 |