Individual
THERESA D TAVENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.D.S.
Contact information
Practice address
2655 ASHMUN ST, SAULT SAINTE MARIE, MI 49783-3711
(906) 632-9809
(888) 977-2109
Mailing address
97 S 4TH ST STE C, ISHPEMING, MI 49849-2168
(906) 228-9699
(888) 977-2109
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
04/24/2018
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