Basic Information
| Provider Information | |||||||||
| NPI: | 1528403672 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARNER DUNKER | ||||||||
| FirstName: | TAMMY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LMT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GARNER | ||||||||
| OtherFirstName: | TAMMY | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherCredential: | LMT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 225 EAGLE CREST ST | ||||||||
| Address2: | |||||||||
| City: | RANGELY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816483105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706754205 | ||||||||
| FaxNumber: | 9706754270 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 EAGLE CREST ST | ||||||||
| Address2: | |||||||||
| City: | RANGELY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816483105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706754205 | ||||||||
| FaxNumber: | 9706754270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2013 | ||||||||
| LastUpdateDate: | 05/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | 0003037 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.