Provider Demographics
NPI:1053528117
Name:SIZEMORE, TAMMY LYNN (OTR)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 BLAIR ROAD
Mailing Address - Street 2:
Mailing Address - City:TYNER
Mailing Address - State:KY
Mailing Address - Zip Code:40486
Mailing Address - Country:US
Mailing Address - Phone:606-364-4447
Mailing Address - Fax:
Practice Address - Street 1:1033 N HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-5478
Practice Address - Country:US
Practice Address - Phone:606-598-6163
Practice Address - Fax:606-598-6163
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist