Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT016988 | PA |
NPI | 1003233875 |
---|---|
Provider Name | Tara Ellen Krammes-Hummel |
First Address | Cherry Hill, NJ 08003-1000 |
Second Address | Devon, PA 19333-1239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2014 |
Last Update Date | 10/08/2015 |