Provider Demographics
NPI:1376820738
Name:UJEK-NARDO, TIFFANY (DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:UJEK-NARDO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44130 LAFFERTY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8770
Mailing Address - Country:US
Mailing Address - Phone:304-559-7743
Mailing Address - Fax:
Practice Address - Street 1:44130 LAFFERTY RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8770
Practice Address - Country:US
Practice Address - Phone:304-559-7743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS5012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist