Fontana, Tatum

Fontana, Tatum is an individual health care provider with primary practice located at 721 Reservoir Ave , Cranston RI 02910-4430. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Fontana, Tatum can be contacted via phone (401) 946-4250.

Contact Information

Primary practice address
721 Reservoir Ave Cranston RI 02910-4430
Phone: (401) 946-4250
Fax: (401) 275-5645
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA00565 Rhode Island

Profile Details

NPI number 1417904061
LBN Legal business name Fontana, Tatum
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417904061 NPPES
Rhode Island Other PTA00565 RHODE ISLAND PTA LICENSE

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