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General NPI Number Information
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NPI Number | 1659056273
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Entity Type | Individual
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Provider Name | TIFFANIE BREEDING
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 3198 US ROUTE 60 STE A
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City | ONA
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State | WV
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Zip | 25545-9507
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Country | US
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Telephone | 304-733-9430
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Fax |
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Provider Business Mailing Address
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Address Line | 18121 CHERRYWOOD DR
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City | CATLETTSBURG
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State | KY
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Zip | 41129-8112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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