Provider Demographics
NPI:1770357329
Name:BYRD, TAMI M (BS, MPT)
Entity type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:M
Last Name:BYRD
Suffix:
Gender:F
Credentials:BS, MPT
Other - Prefix:MS
Other - First Name:TAMI
Other - Middle Name:M
Other - Last Name:ROLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:LYNNVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50153-0211
Mailing Address - Country:US
Mailing Address - Phone:248-252-4276
Mailing Address - Fax:
Practice Address - Street 1:910 E OLIVE ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4175
Practice Address - Country:US
Practice Address - Phone:641-752-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA094293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist