Individual
MRS. TISHA ERIN SCAMMACCA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 SWIFT AVE, NORTH KANSAS CITY, MO 64116
(816) 474-8877
(816) 474-8878
Mailing address
8819 E 57TH ST, RAYTOWN, MO 64133
(816) 743-9518
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2003001814
MO
Other
Enumeration date
12/23/2005
Last updated
07/08/2007
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