Provider Information for 1295368256
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TAMMERA CARBO
Sex: Female
NPI: 1295368256
Last Updated: 2020-02-19
Certification Date: 2020-02-19
Certification Date: 2020-02-19
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295368256 | ||||||||||||||
| Enumeration Date | 2020-02-19 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 150 DU RHU DR APT 102 MOBILE, AL 36608-1221 United States Phone: 251-455-5867 | Fax: | ||||||||||||||
| Primary Practice Address | 150 DU RHU DR APT 102 MOBILE, AL 36608-1221 United States Phone: 251-455-5867 | Fax: | ||||||||||||||
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