Provider Demographics
NPI:1437477098
Name:TAMASANU, CAMELIA EUGENIA (DPT)
Entity Type:Individual
Prefix:
First Name:CAMELIA
Middle Name:EUGENIA
Last Name:TAMASANU
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 1:22521 GLENMOOR HTS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3523
Mailing Address - Country:US
Mailing Address - Phone:248-345-3117
Mailing Address - Fax:
Practice Address - Street 1:23023 ORCHARD LAKE RD STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-3267
Practice Address - Country:US
Practice Address - Phone:248-354-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
MI5501019679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501019679OtherPHYSICAL THERAPY PROFESSIONAL LICENSE