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General NPI Number Information
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NPI Number | 1932666989
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Entity Type | Individual
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Provider Name | TAMMY HARRISON LMT
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Gender | Female
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 4716 E THUNDERBIRD RD STE 151
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City | PHOENIX
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State | AZ
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Zip | 85032-5541
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Country | US
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Telephone | 480-766-8239
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Fax |
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Provider Business Mailing Address
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Address Line | 20425 N 7TH ST APT 3034
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City | PHOENIX
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State | AZ
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Zip | 85024-6018
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Country | US
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Telephone | 480-266-2630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-10390
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License Number State | AZ
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