Individual
TAMMY WHITACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 E 46TH ST, DAVENPORT, IA 52807-3403
(563) 359-3828
Mailing address
2481 HUMMINGBIRD LN, MUSCATINE, IA 52761-8435
(563) 571-1104
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
001242
IA
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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