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Individual

TARA L BRENISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT, MMP

Contact information

Practice address
801 WAYNE ST STE 6, MIDDLEBURY, IN 46540-9074
(480) 221-7514
Mailing address
801 WAYNE ST STE 6, MIDDLEBURY, IN 46540-9074
(480) 221-7514

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT-12663
AZ
225700000X
Massage Therapist
Primary
MT21806621
IN

Other

Enumeration date
06/10/2014
Last updated
02/06/2025
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