Individual
MS. TAMMY LYNN INGRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
3 115TH ST APT 3, TROY, NY 12182-2631
(518) 312-3776
Mailing address
3 115TH ST APT 3, TROY, NY 12182-2631
(518) 312-3776
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002723-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002723-1
NYS P.T.A LICENCE
NY
Enumeration date
03/08/2011
Last updated
03/09/2011
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