MEDICARE: DANA R. DESKINS 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	2002-1065	WV

General Provider Information

NPI Number	:	1437470259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA R. DESKINS LMT

Provider Business Mailing Address
First Line	:	1772 MAPLE ACRES RD
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24739-7352
Country	:	US
Telephone Number	:	304-910-3031
Fax Number	:

Provider Business Practice Location Address
First Line	:	1772 MAPLE ACRES RD
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24739
Country	:	US
Telephone Number	:	304-910-3031
Fax Number	:

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

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	09/10/2019

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