Molly Ann Calandro, LMT
Individual provider Active NPI Massage Therapist · Fenton, MO
NPI 1003135559 · NPPES record last updated May 24, 2010
Key facts
- NPI
- 1003135559
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 2008009697 (MO)
- Practice address
- 220 Gravois Rd
Fenton, MO 63026-4129 - Phone
- (636) 343-0403
- NPI assigned
- May 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008009697 | MO | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2008009697 | MO | Yes |
Addresses
Primary practice location
220 Gravois Rd
Fenton, MO 63026-4129
Mailing address
220 Gravois Rd
Fenton, MO 63026-4129
Phone (636) 343-0403
Other providers in Fenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.