Basic Information
| Provider Information | |||||||||
| NPI: | 1114356334 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARDY | ||||||||
| FirstName: | TAMIKA | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4321 HARTWICK RD | ||||||||
| Address2: | 101 | ||||||||
| City: | COLLEGE PARK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207403210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012776616 | ||||||||
| FaxNumber: | 3012776618 | ||||||||
| Practice Location | |||||||||
| Address1: | 4321 HARTWICK RD | ||||||||
| Address2: | 101 | ||||||||
| City: | COLLEGE PARK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207403210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012776616 | ||||||||
| FaxNumber: | 3012776618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2013 | ||||||||
| LastUpdateDate: | 11/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 24763 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.