Provider Demographics
NPI:1235596685
Name:TANGERE THERAPEUTICS, LLC
Entity Type:Organization
Organization Name:TANGERE THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PHIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:937-298-4325
Mailing Address - Street 1:4090 MARSHALL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5168
Mailing Address - Country:US
Mailing Address - Phone:937-298-4325
Mailing Address - Fax:937-504-5009
Practice Address - Street 1:4090 MARSHALL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-5168
Practice Address - Country:US
Practice Address - Phone:937-298-4325
Practice Address - Fax:937-504-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty