Healthcare Provider Details

I. General information

NPI: 1376799122
Provider Name (Legal Business Name): KATHY HELSINGER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 ENTERPRISE DR
GASSAWAY WV
26624-9333
US

IV. Provider business mailing address

1231 DEEPWELL RD
NETTIE WV
26681-4547
US

V. Phone/Fax

Practice location:
  • Phone: 304-364-4600
  • Fax:
Mailing address:
  • Phone: 304-846-8086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2005-1849
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: