Doctor Name: | CHAD DOUGLAS TANNER |
NPI Number: | 1407989940 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BSWAM LMT,CMT |
License Number: | MAT-9525 |
Business Practice Address: | 4 S Main St Hardwick Inn 3rd Floor Suite 10 Hardwick, VT - 05843 |
Business Phone Number: | 8022793839 |
Business Fax Number: | |
Mailing Address: | Po Box 91, HARDWICK |
State: | VT |
Postal Code: | 058430091 |
Phone Number: | 8022793839 |
Fax Number: | |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 11/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MAT-9525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
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. |