Provider Demographics
NPI:1679970404
Name:JURCHEN, TAMMY DEE (LMT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:DEE
Last Name:JURCHEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50680-7810
Mailing Address - Country:US
Mailing Address - Phone:641-373-7028
Mailing Address - Fax:
Practice Address - Street 1:405 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:WELLSBURG
Practice Address - State:IA
Practice Address - Zip Code:50680-7810
Practice Address - Country:US
Practice Address - Phone:641-373-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007119225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist