Staci Bakerpruitt, LMT
Individual provider Active NPI Massage Therapist · Oglesby, IL
NPI 1811585367 · NPPES record last updated Jan 8, 2021
Key facts
- NPI
- 1811585367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- Practice address
- 105 1/2 W Walnut St
Oglesby, IL 61348-1215 - Phone
- (815) 228-0438
- NPI assigned
- Jan 8, 2021
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | Yes |
Addresses
Primary practice location
105 1/2 W Walnut St
Oglesby, IL 61348-1215
Mailing address
105 1/2 W Walnut St
Oglesby, IL 61348-1215
Phone (815) 228-0438
Other providers in Oglesby, IL
- Alliance Dental Group
- Truletta M Argubright
- Brian Robert Billard
- Patricia Blackburn
- City of Oglesby
- Dental Professionals of Illinois, P.C.
- Bonnie Lynn Dzik
All providers in Oglesby, 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 Jan 8, 2021. 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.