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NPI Code Detail

MEDICARE: MS. TAMMY MARIE HARRIS PTA

MEDICARE: MS. TAMMY MARIE HARRIS PTA
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
1225200000XPhysical Therapy Assistant526-019WI

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 : 1861665267
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TAMMY MARIE HARRIS PTA
Provider Business Mailing Address
First Line : 3205 WOOD RD
Second Line :
City : RACINE
State : WI
Zip : 53406-5048
Country : US
Telephone Number : 262-598-9146
Fax Number : 262-598-1046
Provider Business Practice Location Address
First Line : 3205 WOOD RD
Second Line :
City : RACINE
State : WI
Zip : 53406-5048
Country : US
Telephone Number : 262-598-9146
Fax Number : 262-598-1046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2008
Last Update Date : 08/20/2012

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