Kathryn Devine, LMT
Individual provider Active NPI Massage Therapist · Braidwood, IL
NPI 1205214749 · NPPES record last updated May 18, 2015
Key facts
- NPI
- 1205214749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227017707 (IL)
- Practice address
- 402 W 6TH St
Braidwood, IL 60408-1330 - Phone
- (815) 351-3356
- NPI assigned
- May 18, 2015
- 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 |
|---|---|---|---|
| 227017707 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227017707 | IL | Yes |
Addresses
Primary practice location
402 W 6TH St
Braidwood, IL 60408-1330
Mailing address
402 W 6TH St
Braidwood, IL 60408-1330
Phone (815) 351-3356
Other providers in Braidwood, IL
- Braidwood Volunteer Fire Department
- Jill Chinski
- Odalys Mary Colon Martinez
- April Crawford
- Alexandria De la Rosa
- Doc'S Drugs
- Elite Rehabilitation Institute Braidwood LLC
- Christy Enz
- Ashley Marie Fields
- Laura Gabriel
All providers in Braidwood, IL · Massage Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2015. 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.