Provider Demographics
NPI:1629108634
Name:TROMLEY, BETH ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:TROMLEY
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 1:3311 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47620-9026
Mailing Address - Country:US
Mailing Address - Phone:812-985-7365
Mailing Address - Fax:812-985-3245
Practice Address - Street 1:3311 DAVID DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IN
Practice Address - Zip Code:47620-9026
Practice Address - Country:US
Practice Address - Phone:812-985-7365
Practice Address - Fax:812-985-3245
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist