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NPI Code Detail

MEDICARE: TAMMY LEE DIPPENWORTH LIC. AP

MEDICARE:   TAMMY LEE DIPPENWORTH  LIC. AP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAP 2518FL

General Provider Information

NPI Number : 1245408749
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY LEE DIPPENWORTH LIC. AP
Provider Business Mailing Address
First Line : 3722 S CONWAY RD
Second Line :
City : ORLANDO
State : FL
Zip : 32812-7608
Country : US
Telephone Number : 321-303-5946
Fax Number :
Provider Business Practice Location Address
First Line : 3722 S CONWAY RD
Second Line :
City : ORLANDO
State : FL
Zip : 32812-7608
Country : US
Telephone Number : 321-303-5946
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2008
Last Update Date : 02/19/2009

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Directions to “ TAMMY LEE DIPPENWORTH LIC. AP” Practice Location

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