MEDICARE: TAMARA JULIA CURRY LPTA

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
1	225200000X	Physical Therapy Assistant	117661	MO

General Provider Information

NPI Number	:	1720271398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA JULIA CURRY LPTA

Provider Business Mailing Address
First Line	:	307 GRAND AVE
Second Line	:
City	:	CARROLLTON
State	:	MO
Zip	:	64633-2265
Country	:	US
Telephone Number	:	660-542-1599
Fax Number	:	660-542-0831

Provider Business Practice Location Address
First Line	:	307 GRAND AVE
Second Line	:
City	:	CARROLLTON
State	:	MO
Zip	:	64633-2265
Country	:	US
Telephone Number	:	660-542-1599
Fax Number	:	660-542-0831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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