MEDICARE: MS. DEBORAH LYNN HUNSICKER LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	02869P	AZ

General Provider Information

NPI Number	:	1225655541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH LYNN HUNSICKER LMT

Provider Business Mailing Address
First Line	:	1590 WILLOW CREEK RD
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86301-1164
Country	:	US
Telephone Number	:	928-227-1899
Fax Number	:

Provider Business Practice Location Address
First Line	:	8200 E JACQUE DR
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-6172
Country	:	US
Telephone Number	:	928-227-1899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	11/27/2023

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