Provider Demographics
NPI:1871154369
Name:TAMM, KERBY M (DPT)
Entity type:Individual
Prefix:
First Name:KERBY
Middle Name:M
Last Name:TAMM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 E. MITCHEL RD.
Mailing Address - Street 2:SUITE B.
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-6601
Mailing Address - Country:US
Mailing Address - Phone:231-348-1011
Mailing Address - Fax:231-348-6998
Practice Address - Street 1:8875 M-119
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-9586
Practice Address - Country:US
Practice Address - Phone:231-881-9000
Practice Address - Fax:231-881-9030
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist