Healthcare Provider Details

I. General information

NPI: 1386668069
Provider Name (Legal Business Name): TAMARA ELZEY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 WASHINGTON BLVD
FORT EUSTIS VA
23604-1275
US

IV. Provider business mailing address

661 WASHINGTON BLVD
FORT EUSTIS VA
23604-1275
US

V. Phone/Fax

Practice location:
  • Phone: 757-506-6661
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT19362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: