Provider Demographics
NPI:1194947606
Name:METZ, TAMMY (MSPT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:METZ
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1110
Mailing Address - Country:US
Mailing Address - Phone:203-445-9843
Mailing Address - Fax:203-445-9847
Practice Address - Street 1:181 MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1110
Practice Address - Country:US
Practice Address - Phone:203-445-9843
Practice Address - Fax:203-445-9847
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012753-1225100000X
CT009288225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist