Taylor Buckholz, LMT
Individual provider Active NPI Massage Therapist · Paulden, AZ
NPI 1184497182 · NPPES record last updated Nov 1, 2023
Key facts
- NPI
- 1184497182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MT-29401 (AZ)
- Practice address
- 24125 N Marblehead Ave
Paulden, AZ 86334-3205 - Phone
- (928) 273-9453
- NPI assigned
- Nov 1, 2023
- 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 |
|---|---|---|---|
| MT-29401 | AZ | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT-29401 | AZ | Yes |
Addresses
Primary practice location
24125 N Marblehead Ave
Paulden, AZ 86334-3205
Mailing address
24125 N Marblehead Ave
Paulden, AZ 86334-3205
Other providers in Paulden, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2023. 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.