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NPI 1699658906

NPI 1699658906 : TANA N OSBORNE PTA : ELKTON, MD

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General NPI Number Information
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    NPI Number           |    1699658906
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    Entity Type          |    Individual 
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    Provider Name        |    TANA N OSBORNE PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/26/2025
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    Last Update Date     |    07/26/2025
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Provider Practice Location Address
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    Address Line         |    1 PRICE DR 
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    City                 |    ELKTON
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    State                |    MD
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    Zip                  |    21921-6731
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    Country              |    US
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    Telephone            |    410-398-6474
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    216 ELKMORE RD 
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    City                 |    ELKTON
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    State                |    MD
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    Zip                  |    21921-7231
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    Country              |    US
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    Telephone            |    443-350-6655
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    Fax                  |    443-350-6655
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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       |    A3142
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    J2-0001314
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    License Number State |    DE
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