Provider Demographics
NPI:1548428030
Name:FORWOOD-TUBELL, TAMERIA L (MPT)
Entity Type:Individual
Prefix:
First Name:TAMERIA
Middle Name:L
Last Name:FORWOOD-TUBELL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SIVLEY RD SW
Mailing Address - Street 2:PEDIATRIC THERAPY
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4421
Mailing Address - Country:US
Mailing Address - Phone:256-265-7952
Mailing Address - Fax:256-265-7953
Practice Address - Street 1:120 GOVERNS AVE
Practice Address - Street 2:PEDIATRIC THERAPY
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-265-7952
Practice Address - Fax:256-265-7953
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3985225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist