Penny Lynne Wheeler, LMT
Individual provider Active NPI Massage Therapist · Frohna, MO
NPI 1962765149 · NPPES record last updated Jun 21, 2012
Key facts
- NPI
- 1962765149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 2011039605 (MO)
- Practice address
- 5944 Main St
Frohna, MO 63748-8128 - Phone
- (573) 824-5215
- Fax
- (573) 824-1109
- NPI assigned
- Jun 21, 2012
- 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 |
|---|---|---|---|
| 2011039605 | MO | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2011039605 | MO | Yes |
Addresses
Primary practice location
5944 Main St
Frohna, MO 63748-8128
Mailing address
5944 Main St
P.O. Box 82
Frohna, MO 63748-8128
Phone (573) 824-5215
Other providers in Frohna, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2012. 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.