Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 99033161A | IN |
NPI | 1013283522 |
---|---|
Provider Name | Tammy Scisney |
First Address | Evansville, IN 47715-2794 |
Second Address | Evansville, IN 47715-8198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2012 |
Last Update Date | 26/07/2012 |