Provider Demographics
NPI:1053180885
Name:TEMPLETON, TIA MARIE (LMT)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:MARIE
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3684 HURTGEN CIR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37737-3181
Mailing Address - Country:US
Mailing Address - Phone:239-298-2065
Mailing Address - Fax:
Practice Address - Street 1:232 S CALDERWOOD ST STE L
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2127
Practice Address - Country:US
Practice Address - Phone:239-298-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14023225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist