Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | TE000719L | PA |
NPI | 1013168376 |
---|---|
Provider Name | Mrs. Tammy Jo Delorenzo |
First Address | Pottstown, PA 19464-4607 |
Second Address | Pottstown, PA 19464-4607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 06/10/2008 |