Provider Demographics
NPI:1417463258
Name:ANDERS, TAMSEN C
Entity Type:Individual
Prefix:
First Name:TAMSEN
Middle Name:C
Last Name:ANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:PA
Mailing Address - Zip Code:16611-2715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:360 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2737
Practice Address - Country:US
Practice Address - Phone:814-644-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000402225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant