Individual
MRS. THARA TENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 SUNRISE BLVD, PRESCOTT, AZ 86301-5877
(928) 533-7869
Mailing address
18762 N COMET TRL, MARICOPA, AZ 85138-5808
(928) 533-7869
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/01/2007
Last updated
09/21/2010
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