Provider Demographics
NPI:1487070926
Name:MANNO, TAMMY (PT ASSISTANT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MANNO
Suffix:
Gender:F
Credentials:PT ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 MAGUA DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-3725
Mailing Address - Country:US
Mailing Address - Phone:330-760-6463
Mailing Address - Fax:
Practice Address - Street 1:127 MAGUA DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-3725
Practice Address - Country:US
Practice Address - Phone:330-760-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02825225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant