Most Relevant Information
Provider Data
| NPI Number: | 1003173881 |
| Provider Name: | TAMARA L ICKES LPTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA. 07281 |
Most Important Dates
| Enumeration Date: | 04/18/2012 |
| Last Updated: | 04/18/2012 |
Provider Practice Location
339 E MAPLE ST
NORTH CANTON
OH
447202593
Practice Location Phone/Fax
| Phone: | 3304988200 |
| Fax: |
Provider Mailing Location
339 E MAPLE ST
NORTH CANTON
OH
447202593
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |