Provider Demographics
NPI:1528403672
Name:GARNER DUNKER, TAMMY ANN (LMT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:GARNER DUNKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:ANN
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:225 EAGLE CREST ST
Mailing Address - Street 2:
Mailing Address - City:RANGELY
Mailing Address - State:CO
Mailing Address - Zip Code:81648-3105
Mailing Address - Country:US
Mailing Address - Phone:970-675-4205
Mailing Address - Fax:970-675-4270
Practice Address - Street 1:225 EAGLE CREST ST
Practice Address - Street 2:
Practice Address - City:RANGELY
Practice Address - State:CO
Practice Address - Zip Code:81648-3105
Practice Address - Country:US
Practice Address - Phone:970-675-4205
Practice Address - Fax:970-675-4270
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003037225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist