Healthcare Provider Details

I. General information

NPI: 1306917711
Provider Name (Legal Business Name): KRISTIN S POWERS N.D.,L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 SW 3RD ST STE 4
ANKENY IA
50023-2400
US

IV. Provider business mailing address

1932 SW 3RD ST STE 4
ANKENY IA
50023-2400
US

V. Phone/Fax

Practice location:
  • Phone: 515-964-4771
  • Fax:
Mailing address:
  • Phone: 515-964-4771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number00266
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: