Provider Demographics
NPI:1437240058
Name:TRAMMA, ANTHONY H (MPT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:H
Last Name:TRAMMA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 SCOTT BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1460
Mailing Address - Country:US
Mailing Address - Phone:404-377-1223
Mailing Address - Fax:404-378-4048
Practice Address - Street 1:1382 SCOTT BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1460
Practice Address - Country:US
Practice Address - Phone:404-377-1223
Practice Address - Fax:404-378-4048
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT 002934225100000X
CAPT 22176225100000X
GAPT011350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT22176AMedicare ID - Type Unspecified
P59478Medicare UPIN