Provider Demographics
NPI:1811227655
Name:ANN, TAMMITHA
Entity Type:Individual
Prefix:
First Name:TAMMITHA
Middle Name:
Last Name:ANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 WINDWARD WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3133
Mailing Address - Country:US
Mailing Address - Phone:406-756-8488
Mailing Address - Fax:406-257-4663
Practice Address - Street 1:245 WINDWARD WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3133
Practice Address - Country:US
Practice Address - Phone:406-756-8488
Practice Address - Fax:406-257-4663
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist