Individual
TOMICO CAMILLE SPEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
1515 AUTUMN DR, CROWN POINT, IN 46307-9691
(414) 324-1009
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005807A
IN
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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