Provider Demographics
NPI:1619028875
Name:KARP, TAMMY R (DC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:R
Last Name:KARP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3510
Mailing Address - Country:US
Mailing Address - Phone:906-225-8000
Mailing Address - Fax:906-225-8000
Practice Address - Street 1:1012 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-3510
Practice Address - Country:US
Practice Address - Phone:906-225-8000
Practice Address - Fax:906-225-8000
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU83199Medicare ID - Type Unspecified