Individual
MRS. TAMMY LISA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
58 LOCKE DR, BINGHAMTON, NY 13903-2328
(607) 772-7670
Mailing address
58 LOCKE DR, BINGHAMTON, NY 13903-2328
(607) 772-7670
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6514794
NY
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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