NPI 1194356121 · live from the CMS NPI Registry
Ivan Pancic
Massage Therapist in Overland Park, KS. National Provider Identifier 1194356121, active.
NPI record
| NPI | 1194356121 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 10841 W 87th St Ste 200, Overland Park, KS 66214 |
| Practice phone | 913-825-3900 |
| Mailing address | 7428 N Hunter Ct, Kansas City, MO 64158 |
| Enumerated | January 29, 2020 |
| Last updated | January 29, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | THR-0655677 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.