Della Mae Deventuri, LMT

Individual provider Active NPI Massage Therapist · Pulaski, TN

NPI 1184826554 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1184826554
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT0000002391 (TN)
Practice address
2735 Ball Hollow Rd
Pulaski, TN 38478-6634
Phone
(931) 424-5600
NPI assigned
Jun 5, 2007
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

LicenseStateTypeSpecialty
MT0000002391TNMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT0000002391 TN Yes

Addresses

Primary practice location

2735 Ball Hollow Rd
Pulaski, TN 38478-6634

Mailing address

2735 Ball Hollow Rd
Pulaski, TN 38478-6634
Phone (931) 424-5600

Other providers in Pulaski, TN

All providers in Pulaski, TN · Massage Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.