George Koukouves, L.M.T.

Individual provider Active NPI Massage Therapist · Carefree, AZ

NPI 1477813871 · NPPES record last updated May 21, 2012

Key facts

NPI
1477813871
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT-03432P (AZ)
Practice address
36800 N. Sidewinder
A-8
Carefree, AZ 85377
Phone
(480) 363-0091
Fax
(480) 575-1181
NPI assigned
May 21, 2012
Sex
Male
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
MT-03432PAZMDMechanotherapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X MT-03432P AZ
Massage Therapist 225700000X MT-03432P AZ Yes

Addresses

Primary practice location

36800 N. Sidewinder
A-8
Carefree, AZ 85377

Mailing address

15734 E Sycamore Dr
Fountain Hills, AZ 85268-4371
Phone (480) 836-6888

Other providers in Carefree, AZ

All providers in Carefree, AZ · Massage Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.