Denise Lynn Cannon, LMT – Massage Therapist

Key facts

NPI: 1376320234
Entity type: Individual (NPI type 1)
Primary specialty: Massage Therapist 225700000X
License: 227.000129 (IL)
Practice address: River Valley Physical Therapy
535 E. North Street, Suite C
Bradley, IL 60915
Phone: (815) 802-7503
NPI assigned: Sep 13, 2023
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

River Valley Physical Therapy Spine and Joint Center LLC Physical Therapist · Bradley, IL · NPI 1144401233

NPD

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
227.000129	IL	MD	Massage Therapist

Practice roles

Organization	Specialty	Status	New patients
River Valley Physical Therapy Spine and Joint Center LLC		Current since Sep 17, 2023	Accepting new patients

Locations

535 E North St
Ste C
Bradley, IL 60915
Phone (815) 802-7503

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Massage Therapist	225700000X	227.000129	IL	Yes

Addresses

Primary practice location

River Valley Physical Therapy
535 E. North Street, Suite C
Bradley, IL 60915

Mailing address

147 S Forest Ave
Bradley, IL 60915-2027
Phone (773) 318-8526

Other providers in Bradley, IL

All providers in Bradley, 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 Sep 13, 2023. 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.

Verify at the official NPI Registry.