Leanne Michelle Fairchok, LMT

Individual provider Active NPI Massage Therapist · Enola, PA

NPI 1255973608 · NPPES record last updated Oct 16, 2019

Key facts

NPI
1255973608
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MSG011835 (PA)
Practice address
125 N Enola Dr Ste 203
Enola, PA 17025-2500
Phone
(717) 343-0890
NPI assigned
Oct 16, 2019
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
MSG011835PAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225700000X MSG011835 PA Yes

Addresses

Primary practice location

125 N Enola Dr Ste 203
Enola, PA 17025-2500

Mailing address

202 Valley St
Enola, PA 17025-1649
Phone (717) 343-0890

Other providers in Enola, PA

All providers in Enola, PA · Massage Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.