Provider Demographics
NPI:1306516505
Name:PRINGLE, TAHNESE (LMT)
Entity type:Individual
Prefix:MS
First Name:TAHNESE
Middle Name:
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 PHILADELPHIA ST STE 6
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8785
Mailing Address - Country:US
Mailing Address - Phone:515-292-8684
Mailing Address - Fax:
Practice Address - Street 1:2010 PHILADELPHIA ST STE 6
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8785
Practice Address - Country:US
Practice Address - Phone:515-292-8684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist