Tamara G Green, PT

Individual provider Active NPI Physical Therapist · Lambertville, MI

NPI 1619904539 · NPPES record last updated Sep 17, 2014

Key facts

NPI
1619904539
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501016333 (MI)
Practice address
7300 Secor Rd
Lambertville, MI 48144-9376
Phone
(734) 854-1260
Fax
(734) 854-3581
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5501016333MIMDPhysical Therapist
PT010778OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healtherapy Partners Inc Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT010778 OH
Physical Therapist 225100000X 5501016333 MI Yes

Addresses

Primary practice location

7300 Secor Rd
Lambertville, MI 48144-9376

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other identifiers

IdentifierTypeStateIssuer
000000168967OtherANTHEM

Other names

  • Tamara G White Former name

Other providers in Lambertville, MI

All providers in Lambertville, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.