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General NPI Number Information
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NPI Number | 1215525415
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Entity Type | Individual
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Provider Name | CATINA FIONNE RADFORD CMT
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Gender | Female
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 7895 BROADWAY STE C
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5529
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Country | US
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Telephone | 219-789-5759
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Fax |
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Provider Business Mailing Address
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Address Line | 303 W 80TH PL UNIT 10072
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City | MERRILLVILLE
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State | IN
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Zip | 46411-5804
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Country | US
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Telephone | 219-713-0047
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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 | MT20900536
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License Number State | IN
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