Provider Demographics
NPI:1871655324
Name:RECESSO, TAMI J (MPT)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:J
Last Name:RECESSO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2932
Mailing Address - Country:US
Mailing Address - Phone:603-382-3336
Mailing Address - Fax:603-382-3633
Practice Address - Street 1:11 GARDEN RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2932
Practice Address - Country:US
Practice Address - Phone:603-382-3336
Practice Address - Fax:603-382-3633
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2766174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist