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1215325774
TARA ELLAN KEMNITZ
GILBERT, AZ
NPI
1215325774
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Former Name
TARA ELLAN BIVENS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: AZ #MT-20238)
Enumeration Date
2015-01-06
Last Update Date
2015-01-06
Business Address
-- TARA ELLAN KEMNITZ LMT
1467 W ELLIOT RD STE 103
GILBERT, AZ 85233-5167
Phone number: 503-701-1039
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Mailing Address
-- TARA ELLAN KEMNITZ LMT
11336 E ROSCOE AVE
MESA, AZ 85212-4125
Phone number: 503-701-1039
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