Doctor Name: | BERNADETTE TIFFANY |
NPI Number: | 1376885749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA, LMT,CFT |
License Number: | MT.0006224 |
Business Practice Address: | 126 W D St Suite 100c Pueblo, CO - 810033451 |
Business Phone Number: | 7192403745 |
Business Fax Number: | 7195452807 |
Mailing Address: | 126 W D St, Suite 100c PUEBLO |
State: | CO |
Postal Code: | 810033451 |
Phone Number: | 7192403745 |
Fax Number: | 7195452807 |
NPI Enumeration Date: | 03/22/2013 |
NPI Last Update Date: | 03/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT.0006224 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
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. |