Provider Demographics
NPI:1629077300
Name:FREEMAN, TAMMY T (PT)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:T
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 JEFFERSON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-6563
Mailing Address - Country:US
Mailing Address - Phone:540-967-1757
Mailing Address - Fax:540-967-0817
Practice Address - Street 1:115 JEFFERSON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-6563
Practice Address - Country:US
Practice Address - Phone:540-967-1757
Practice Address - Fax:540-967-0817
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010064996Medicaid