Provider Demographics
NPI:1740997725
Name:BAMFORD, ESTHER RUTH
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:RUTH
Last Name:BAMFORD
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 1:3911 E WHITTIER ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-4152
Mailing Address - Country:US
Mailing Address - Phone:520-305-0334
Mailing Address - Fax:
Practice Address - Street 1:7500 N CALLE SIN ENVIDIA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-7300
Practice Address - Country:US
Practice Address - Phone:520-742-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist