Provider Demographics
NPI:1447849948
Name:WINKLER, TANA LEE (LMT)
Entity type:Individual
Prefix:MRS
First Name:TANA
Middle Name:LEE
Last Name:WINKLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:TANA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:4900 S HIGHLAND CIR APT 10
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-6107
Mailing Address - Country:US
Mailing Address - Phone:801-830-7800
Mailing Address - Fax:
Practice Address - Street 1:4900 S HIGHLAND CIR APT 10
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-6107
Practice Address - Country:US
Practice Address - Phone:801-830-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9268759-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist