Healthcare Provider Details

I. General information

NPI: 1285961946
Provider Name (Legal Business Name): TIFFANIE CHAMBERLAIN MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2009
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 MOUNT CARMEL TOBASCO RD SUITE 324
CINCINNATI OH
45255-3400
US

IV. Provider business mailing address

4030 MOUNT CARMEL TOBASCO RD SUITE 324
CINCINNATI OH
45255-3400
US

V. Phone/Fax

Practice location:
  • Phone: 513-284-4533
  • Fax:
Mailing address:
  • Phone: 513-284-4533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.008354
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: