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NPI Code Detail

MEDICARE: TAMMY LEE PT

MEDICARE: TAMMY LEE 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 TherapistIL

General Provider Information

NPI Number : 1609051309
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY LEE PT
Provider Business Mailing Address
First Line : 411 N CEDAR AVE
Second Line :
City : WOOD DALE
State : IL
Zip : 60191-1510
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 305 CHERRY ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-1803
Country : US
Telephone Number : 800-974-6383
Fax Number : 800-974-4241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2008
Last Update Date : 01/01/2008

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