Individual
TAWNEE BENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
97 PIKE ST, ROCHEPORT, MO 65279-9392
(573) 489-6383
Mailing address
PO BOX 45, ROCHEPORT, MO 65279-0045
(573) 489-6383
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
2018041781
MO
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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