Provider Demographics
NPI:1467528158
Name:BARTZ, TAMMY JEAN (RD)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:JEAN
Last Name:BARTZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:ATTN DIABETIC EDUCATION
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-4427
Mailing Address - Fax:810-342-4428
Practice Address - Street 1:401 S BALLENGER HWY
Practice Address - Street 2:ATTN DIABETIC EDUCATION
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3638
Practice Address - Country:US
Practice Address - Phone:810-342-4427
Practice Address - Fax:810-342-4428
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL643502133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered