Provider Demographics
NPI:1043075575
Name:STREHLOW, TAMMY ANN (MA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:STREHLOW
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-2624
Mailing Address - Country:US
Mailing Address - Phone:715-539-6641
Mailing Address - Fax:715-201-3341
Practice Address - Street 1:1302 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-2624
Practice Address - Country:US
Practice Address - Phone:715-539-6641
Practice Address - Fax:715-201-3341
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service