Phillip D Dennis, L.M.T.
Individual provider Active NPI Massage Therapist · Alexandria, KY
NPI 1831210046 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831210046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- KY-1628 (KY)
- Practice address
- 363 Creek Trace Rd
Alexandria, KY 41001 - Phone
- (859) 635-1095
- NPI assigned
- Apr 3, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| KY-1628 | KY | MD | Massage Therapist |
| 33-014292 | OH | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | KY-1628 | KY | Yes |
| Massage Therapist | 225700000X | 33-014292 | OH |
Addresses
Primary practice location
363 Creek Trace Rd
Alexandria, KY 41001
Mailing address
363 Creek Trace Rd
Alexandria, KY 41001
Phone (859) 635-1095
Other providers in Alexandria, KY
- Kevin E. Crowley
- Stephanie Crowley
- Kristen Harrell Cummins
- Christen Davis
- Derek M Demaison
- Derek Downing
- Catherine Nicole Ellis
- Julie Lynn Enzweiler
- James Maxwell Ernst
- Amy Farris
All providers in Alexandria, KY · Massage Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.