Tamara Lee Epperson

Individual provider Active NPI Massage Therapist · Knob Noster, MO

NPI 1295252575 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1295252575
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
2013042457 (MO)
Practice address
471 NE 601
Knob Noster, MO 65336-1839
Phone
(660) 624-1935
NPI assigned
Aug 28, 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

LicenseStateTypeSpecialty
2013042457MOMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 2013042457 MO Yes

Addresses

Primary practice location

471 NE 601
Knob Noster, MO 65336-1839

Mailing address

471 NE 601
Knob Noster, MO 65336-1839
Phone (660) 624-1935

Other providers in Knob Noster, MO

All providers in Knob Noster, MO · Massage Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.