Doctor Name: | COURTNEY TANNER |
NPI Number: | 1083043327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LMT-LMT-LIC-4317 |
Business Practice Address: | 619 S Washington St Moscow, ID - 838433090 |
Business Phone Number: | 2088834300 |
Business Fax Number: | 2088834311 |
Mailing Address: | 619 S Washington St, MOSCOW |
State: | ID |
Postal Code: | 838433090 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 11/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | LMT-LMT-LIC-4317 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |