Provider Demographics
NPI:1235450289
Name:BIERY, TAMI RACHELE (MPT)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:RACHELE
Last Name:BIERY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 LARKSPUR LN
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-9600
Mailing Address - Country:US
Mailing Address - Phone:208-305-6896
Mailing Address - Fax:
Practice Address - Street 1:216 LARKSPUR LN
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-9600
Practice Address - Country:US
Practice Address - Phone:208-305-6896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008873225100000X
IDPT1693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist