Individual
TAMARA S HERMANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3385 DEXTER CT STE 203, DAVENPORT, IA 52807-3471
(563) 332-9312
(563) 332-9316
Mailing address
850 43RD AVE STE 100, MOLINE, IL 61265-8401
(309) 743-2070
(309) 743-2073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00808
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00808
IOWA PT LICENSE NUMBER
IA
Enumeration date
05/30/2006
Last updated
05/29/2008
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