Provider Demographics
NPI:1912183401
Name:DANILUCK, TAMMY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:DANILUCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:NEVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 SHREWSBURY COMMONS AVE
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1616
Mailing Address - Country:US
Mailing Address - Phone:717-227-2230
Mailing Address - Fax:717-227-0509
Practice Address - Street 1:600 SHREWSBURY COMMONS AVE
Practice Address - Street 2:SUITE 9A
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1616
Practice Address - Country:US
Practice Address - Phone:717-227-2230
Practice Address - Fax:717-227-0509
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist