Healthcare Provider Details

I. General information

NPI: 1386270478
Provider Name (Legal Business Name): TAMBRA W CHAMBERS MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7324 BRADLEY BLVD
BETHESDA MD
20817-2130
US

IV. Provider business mailing address

7324 BRADLEY BLVD
BETHESDA MD
20817-2130
US

V. Phone/Fax

Practice location:
  • Phone: 301-273-5299
  • Fax: 855-232-8604
Mailing address:
  • Phone: 301-273-5299
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number19519
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: