Provider Demographics
NPI:1497946057
Name:DUFFIN, TAMMY ELLEN (LMT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ELLEN
Last Name:DUFFIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 CRESTHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-9445
Mailing Address - Country:US
Mailing Address - Phone:352-835-1516
Mailing Address - Fax:
Practice Address - Street 1:327 CRESTHAVEN CT
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-9445
Practice Address - Country:US
Practice Address - Phone:352-835-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 50204225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist