Danielle Bowen, LMT
Individual provider Active NPI Massage Therapist · Rexburg, ID
NPI 1356790620 · NPPES record last updated Jun 8, 2016
Key facts
- NPI
- 1356790620
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MAS-2768 (ID)
- Practice address
- 32 Carlson Ave
Rexburg, ID 83440-1914 - Phone
- (208) 557-3516
- NPI assigned
- Jun 8, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| MAS-2768 | ID | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Del Holdings, LLC | Massage Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAS-2768 | ID | Yes |
Addresses
Primary practice location
32 Carlson Ave
Rexburg, ID 83440-1914
Mailing address
32 Carlson Ave
Rexburg, ID 83440-1914
Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2016. 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.