Healthcare Provider Details

I. General information

NPI: 1710127584
Provider Name (Legal Business Name): GERALDINE HUNN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 S JACKSON ST APT B
SAN ANGELO TX
76901-4369
US

IV. Provider business mailing address

1313 S JACKSON ST APT B
SAN ANGELO TX
76901-4369
US

V. Phone/Fax

Practice location:
  • Phone: 325-212-6742
  • Fax:
Mailing address:
  • Phone: 325-212-6742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMT005194
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: