Provider Demographics
NPI:1891097200
Name:ERWIN, TAMMY HYATT (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:HYATT
Last Name:ERWIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PALMETTO POINTE RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-6722
Mailing Address - Country:US
Mailing Address - Phone:843-289-0241
Mailing Address - Fax:843-423-4478
Practice Address - Street 1:112 PALMETTO POINTE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-6722
Practice Address - Country:US
Practice Address - Phone:843-289-0241
Practice Address - Fax:843-423-4478
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7281225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist