Shannon Lindow, LMT

Individual provider Active NPI Massage Therapist · Cordova, AK

NPI 1790248607 · NPPES record last updated Apr 8, 2019

Key facts

NPI
1790248607
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
0021393 (CO)
Practice address
520 2ND St
Cordova, AK 99574
Phone
(907) 429-7797
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

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.

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
0021393COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture & Wellness of Cordova Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0021393 CO Yes

Addresses

Primary practice location

520 2ND St
Cordova, AK 99574

Mailing address

PO Box 1612
Cordova, AK 99574-1612

Other providers in Cordova, AK

All providers in Cordova, AK · Massage Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.