Lisa Margo Bynum
Individual provider Active NPI Massage Therapist · Paris, AR
NPI 1881397446 · NPPES record last updated Mar 24, 2023
Key facts
- NPI
- 1881397446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 8630 (AR)
- Practice address
- 307 Pennington Drive
Paris, AR 72855 - Phone
- (479) 438-4979
- NPI assigned
- Mar 23, 2023
- 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 |
|---|---|---|---|
| 8630 | AR | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 8630 | AR | Yes |
Addresses
Primary practice location
307 Pennington Drive
Paris, AR 72855
Mailing address
307 Pennington Drive
Paris, AR 72855
Phone (479) 438-4979
Other providers in Paris, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2023. 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.