Healthcare Provider Details

I. General information

NPI: 1245456250
Provider Name (Legal Business Name): TAMSEN MARIE NEUMANN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 CHRISTIE PL
OWENSBORO KY
42301-5956
US

IV. Provider business mailing address

3303 CHRISTIE PL
OWENSBORO KY
42301-5956
US

V. Phone/Fax

Practice location:
  • Phone: 270-485-4196
  • Fax:
Mailing address:
  • Phone: 270-485-4196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008345
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA02040
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: