Provider Demographics
NPI:1174826721
Name:NAUMAN, TAMMY U (PTA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:U
Last Name:NAUMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 RUSSETT LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-3622
Mailing Address - Country:US
Mailing Address - Phone:414-764-6830
Mailing Address - Fax:
Practice Address - Street 1:3414 RUSSETT LN
Practice Address - Street 2:
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-3622
Practice Address - Country:US
Practice Address - Phone:414-764-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI593-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant