MEDICARE: TAMMY HARRISON LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT-10390	AZ

General Provider Information

NPI Number	:	1932666989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY HARRISON LMT

Provider Business Mailing Address
First Line	:	20425 N 7TH ST APT 3034
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-6018
Country	:	US
Telephone Number	:	480-266-2630
Fax Number	:

Provider Business Practice Location Address
First Line	:	4716 E THUNDERBIRD RD STE 151
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-5541
Country	:	US
Telephone Number	:	480-766-8239
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/26/2019

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