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General NPI Number Information
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NPI Number | 1124789953
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Entity Type | Individual
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Provider Name | MATTHEW TUMA
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Gender | Male
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 7410 SWITZER RD
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City | SHAWNEE
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State | KS
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Zip | 66203-4550
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Country | US
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Telephone | 913-335-0353
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Fax |
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Provider Business Mailing Address
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Address Line | 15365 S ALDEN ST
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City | OLATHE
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State | KS
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Zip | 66062-3381
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Country | US
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Telephone | 720-335-3706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MEL17-2693
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License Number State | KS
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