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General NPI Number Information
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NPI Number | 1245854017
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Entity Type | Individual
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Provider Name | DANNEY LESTER HENDRIX MT
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Gender | Male
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 5485 ATLANTA HWY ROOT SALON BUILDING
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City | MONTGOMERY
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State | AL
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Zip | 36109
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Country | US
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Telephone | 334-300-0389
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Fax |
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Provider Business Mailing Address
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Address Line | 6721 POST OAK LN
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City | MONTGOMERY
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State | AL
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Zip | 36117-2423
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Country | US
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Telephone | 133-430-0038
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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 | 404
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License Number State | AL
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