Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT013524L | PA |
NPI | 1003229816 |
---|---|
Provider Name | Tammy Pfeiffer |
First Address | Titusville, PA 16354-2108 |
Second Address | Titusville, PA 16354-2108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 09/06/2014 |