Provider Demographics
NPI:1447272331
Name:TEW, PEGGY MARIE (CMT)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:MARIE
Last Name:TEW
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2723
Mailing Address - Country:US
Mailing Address - Phone:610-864-2639
Mailing Address - Fax:
Practice Address - Street 1:202 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2723
Practice Address - Country:US
Practice Address - Phone:610-864-2639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist