Provider Demographics
NPI:1346647138
Name:SLANKER, TAMRA LYN (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:TAMRA
Middle Name:LYN
Last Name:SLANKER
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 N HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1310
Mailing Address - Country:US
Mailing Address - Phone:714-870-8478
Mailing Address - Fax:
Practice Address - Street 1:1027 N HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1310
Practice Address - Country:US
Practice Address - Phone:714-870-8478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-23
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist