Individual
TAMMY ABENDROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
905 E MAIN ST, OLNEY, IL 62450-2623
(618) 393-7732
(618) 395-3123
Mailing address
905 E MAIN ST, OLNEY, IL 62450-2623
(618) 393-7732
(618) 395-3123
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160003708
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8030288
BLUECROSS/BLUESHIELD IL
IL
Enumeration date
08/20/2006
Last updated
07/25/2013
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