NPI 1174033708 · live from the CMS NPI Registry
Deidre Joy Banahan
Massage Therapist in Belleville, KS. National Provider Identifier 1174033708, active.
NPI record
| NPI | 1174033708 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 1913 M St, Belleville, KS 66935 |
| Practice phone | 785-955-2233 |
| Mailing address | 205 Beach St, Cuba, KS 66940 |
| Enumerated | October 10, 2017 |
| Last updated | October 10, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 3225 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.