Lillian Decker, LMT
Individual provider Active NPI Massage Therapist · Elmore, OH
NPI 1285155358 · NPPES record last updated Jun 29, 2017
Key facts
- NPI
- 1285155358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 022222 (OH)
- Practice address
- 360 Rice St
Elmore, OH 43416-9422 - Phone
- (419) 463-2559
- NPI assigned
- Jun 29, 2017
- 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 |
|---|---|---|---|
| 022222 | OH | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 022222 | OH | Yes |
Addresses
Primary practice location
360 Rice St
Elmore, OH 43416-9422
Mailing address
1818 Hayes Ave
Fremont, OH 43420-2709
Phone (419) 463-2559
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022222 | Other | OH | LICENSED MASSAGE THERAPIST |
Other names
- Lilley Decker
Other providers in Elmore, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2017. 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.