Healthcare Provider Details

I. General information

NPI: 1801881925
Provider Name (Legal Business Name): TERA HAMO ANDERSON D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERA KAY HAMO D.C.

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 W HILL RD SUITE 2
FLINT MI
48507-4776
US

IV. Provider business mailing address

1174 W HILL RD SUITE 2
FLINT MI
48507-4776
US

V. Phone/Fax

Practice location:
  • Phone: 810-238-9066
  • Fax: 810-238-9139
Mailing address:
  • Phone: 810-238-9066
  • Fax: 810-238-9139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301008899
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3994
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: