Tanya Lynn Broadfoot, MASSAGE THERAPIST

Individual provider Active NPI Massage Therapist · Kearney, NE

NPI 1891291530 · NPPES record last updated Apr 2, 2018

Key facts

NPI
1891291530
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
1725 (NE)
Practice address
2610 2ND Ave
Kearney, NE 68847-4417
Phone
(308) 293-7423
NPI assigned
Apr 2, 2018
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

LicenseStateTypeSpecialty
1725NEMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225700000X 1725 NE Yes

Addresses

Primary practice location

2610 2ND Ave
Kearney, NE 68847-4417

Mailing address

2610 2ND Ave
Kearney, NE 68847-4417
Phone (308) 293-7423

Other providers in Kearney, NE

All providers in Kearney, NE · Massage Therapist in Nebraska

Sources for this page

Verify at the official NPI Registry.