Provider Demographics
NPI:1124227293
Name:BUFFERY, TAMMY (LMT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:BUFFERY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 NOOSENECK HILL RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-1568
Mailing Address - Country:US
Mailing Address - Phone:401-385-9530
Mailing Address - Fax:401-385-9532
Practice Address - Street 1:28 NOOSENECK HILL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:WEST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02817-1568
Practice Address - Country:US
Practice Address - Phone:401-385-9530
Practice Address - Fax:401-385-9532
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMT01302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist