Provider Demographics
NPI:1669841714
Name:HAMM, TIFANI (DPT)
Entity Type:Individual
Prefix:
First Name:TIFANI
Middle Name:
Last Name:HAMM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6108 CARLISLE PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-5243
Mailing Address - Country:US
Mailing Address - Phone:717-591-9118
Mailing Address - Fax:
Practice Address - Street 1:6108 CARLISLE PIKE STE 102
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-5243
Practice Address - Country:US
Practice Address - Phone:717-591-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist