MEDICARE: TAMMY BREE

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	MT20901859	IN

General Provider Information

NPI Number	:	1750778155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY BREE

Provider Business Mailing Address
First Line	:	3024 N DELAWARE ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3917
Country	:	US
Telephone Number	:	317-600-4627
Fax Number	:

Provider Business Practice Location Address
First Line	:	3024 N DELAWARE ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3917
Country	:	US
Telephone Number	:	317-600-4627
Fax Number	:

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

Provider Enumeration Date	:	04/23/2015
Last Update Date	:	04/23/2015

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Directions to “ TAMMY BREE ” Practice Location

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