Individual
CHAD DOUGLAS TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSWAM LMT,CMT
Contact information
Practice address
4 S MAIN ST, HARDWICK INN 3RD FLOOR SUITE 10, HARDWICK, VT 05843
(802) 279-3839
Mailing address
PO BOX 91, HARDWICK, VT 05843-0091
(802) 279-3839
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-9525
HI
Other
Enumeration date
03/13/2007
Last updated
11/02/2011
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