Individual
TARA ELLAN KEMNITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1467 W ELLIOT RD STE 103, GILBERT, AZ 85233-5167
(503) 701-1039
Mailing address
11336 E ROSCOE AVE, MESA, AZ 85212-4125
(503) 701-1039
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
#MT-20238
AZ
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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