Kalen Tenderness Tierney

Individual provider Active NPI Massage Therapist · Dummerston, VT

NPI 1447002191 · NPPES record last updated Apr 4, 2024

Key facts

NPI
1447002191
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
164.0001598 (VT)
Practice address
1965 E West Rd
Dummerston, VT 05301-4449
Phone
(610) 914-2958
NPI assigned
Apr 4, 2024
Sex
Unspecified or another gender identity
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
164.0001598VTMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 164.0001598 VT Yes

Addresses

Primary practice location

1965 E West Rd
Dummerston, VT 05301-4449

Mailing address

1965 E West Rd
Dummerston, VT 05301-4449
Phone (610) 914-2958

Other providers in Dummerston, VT

All providers in Dummerston, VT · Massage Therapist in Vermont

Sources for this page

Verify at the official NPI Registry.