Alicia David
Individual provider Active NPI Massage Therapist · Brusly, LA
NPI 1740630441 · NPPES record last updated Jun 14, 2016
Key facts
- NPI
- 1740630441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- LA8219 (LA)
- Practice address
- 822 E Main St
Brusly, LA 70719-2215 - Phone
- (225) 931-0082
- NPI assigned
- Jun 14, 2016
- 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 |
|---|---|---|---|
| LA8219 | LA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | LA8219 | LA | Yes |
Addresses
Primary practice location
822 E Main St
Brusly, LA 70719-2215
Mailing address
822 East Main St
Brusly, LA 70719
Phone (318) 359-1766
Other providers in Brusly, LA
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- Tamiko Clayton
- Convenient Care LLC
- Allison P Cutrer
- Daniel Pharmacy LLC
- Donald H. De Latin
- Wendy R Devall
- Dynamic Therapy, LLC
- Dynamic Therapy, LLC
- Tonnisha Ellis
All providers in Brusly, LA · Massage Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 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.