Provider Demographics
NPI:1467720938
Name:HALE, TAMARA (LMT, CMT)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-1358
Mailing Address - Country:US
Mailing Address - Phone:803-604-7402
Mailing Address - Fax:
Practice Address - Street 1:1345 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-1358
Practice Address - Country:US
Practice Address - Phone:803-604-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6783175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath