Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1689695157 |
---|---|
Provider Name | Ms. Tammy Lorraine Dixon-Williams |
First Address | Bloomfield, NJ 07003-2726 |
Second Address | East Orange, NJ 07018-1023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |