Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 02146 | MO |
NPI | 1245545755 |
---|---|
Provider Name | Mrs. Tammy Lynn Wehmeyer |
First Address | Lake St Louis, MO 63367-1478 |
Second Address | Lake St Louis, MO 63367-1478 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 10/08/2010 |