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NPI Code Detail

MEDICARE: TAMMY KASPROWICZ PT

MEDICARE: TAMMY KASPROWICZ PT
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
1225100000XPhysical Therapist5769MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538257340
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY KASPROWICZ PT
Provider Business Mailing Address
First Line : 7541 9TH ST N
Second Line :
City : OAKDALE
State : MN
Zip : 55128-6626
Country : US
Telephone Number : 651-748-4338
Fax Number :
Provider Business Practice Location Address
First Line : 146 LAKE ST N
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-2518
Country : US
Telephone Number : 651-464-8502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/02/2009

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