NPI 1801102447 · live from the CMS NPI Registry
Ibrahima S Sidibe, massage therapist
Massage Therapist in Hattiesburg, MS. National Provider Identifier 1801102447, active.
NPI record
| NPI | 1801102447 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 6555 Us 98 West, Suite A, Hattiesburg, MS 39402 |
| Practice phone | 601-261-0191 |
| Mailing address | 6555 U S Highway 98, Suite A, Hattiesburg, MS 39402 |
| Enumerated | August 20, 2010 |
| Last updated | August 20, 2010 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | LMT0403 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.