Individual
TAMMY OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
247 TIOGA ST, WELLSBORO, PA 16901-6776
(570) 724-2424
(570) 724-2425
Mailing address
247 TIOGA STREET, WELLSBORO, PA 16901
(570) 724-2424
(570) 724-2425
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
462809249
PA
172A00000X
Driver
462809249
PA
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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