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NPI Code Detail

MEDICARE: MRS. TAMMY L DAVIS PT

MEDICARE: MRS. TAMMY L DAVIS PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist104249MO

General Provider Information

NPI Number : 1033448220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAMMY L DAVIS PT
Provider Business Mailing Address
First Line : 335 HUMES LN
Second Line :
City : FLORISSANT
State : MO
Zip : 63031-3005
Country : US
Telephone Number : 314-921-1603
Fax Number :
Provider Business Practice Location Address
First Line : 936 CHARBONIER RD
Second Line :
City : FLORISSANT
State : MO
Zip : 63031-5220
Country : US
Telephone Number : 314-831-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2009
Last Update Date : 12/16/2009

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Directions to “ MRS. TAMMY L DAVIS PT” Practice Location

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