Individual
MS. TARA CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7989 SOUTHTOWN CTR STE 110, BLOOMINGTON, MN 55431-1323
(612) 987-3464
Mailing address
10225 CLINTON AVE S, BLOOMINGTON, MN 55420-5335
(612) 987-3464
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2201602
MN
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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