Tackett, Larry

Tackett, Larry is an sole proprietor health care provider with primary practice located at 316 Miller Ave Ste F , Mill Valley CA 94941-2887. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Tackett, Larry can be contacted via phone (415) 419-1684.

Contact Information

Primary practice address
316 Miller Ave Ste F Mill Valley CA 94941-2887
Phone: (415) 419-1684
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X

Profile Details

NPI number 1053886291
LBN Legal business name Tackett, Larry
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2018
Last updated Oct 3rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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