James Maxwell

Individual provider Active NPI Massage Therapist · Lansing, WV

NPI 1124346358 · NPPES record last updated Feb 8, 2012

Key facts

NPI
1124346358
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
2000-0461 (WV)
Practice address
1 Ames Heights Road
Lansing, WV 25862
Phone
(304) 573-1195
NPI assigned
May 12, 2010
Sex
Male
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

LicenseStateTypeSpecialty
2000-0461WVMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 2000-0461 WV Yes

Addresses

Primary practice location

1 Ames Heights Road
Lansing, WV 25862

Mailing address

811 Stonehouse Rd
Rainelle, WV 25962-6593
Phone (304) 573-1195

Other providers in Lansing, WV

All providers in Lansing, WV · Massage Therapist in West Virginia

Sources for this page

Verify at the official NPI Registry.