Provider Demographics
NPI:1023360229
Name:CIHA, TAMARA RUTH (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:RUTH
Last Name:CIHA
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MS
Other - First Name:TAMARA
Other - Middle Name:RUTH
Other - Last Name:HINCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1070 N PARK DR
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9301
Mailing Address - Country:US
Mailing Address - Phone:734-847-6036
Mailing Address - Fax:734-847-5667
Practice Address - Street 1:1070 NORTH PARK DR
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182
Practice Address - Country:US
Practice Address - Phone:734-847-6036
Practice Address - Fax:734-847-5667
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502000257247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other