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General NPI Number Information
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NPI Number | 1255044731
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Entity Type | Individual
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Provider Name | KASEY MICHELLE SLAGLE LMT
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Gender | Female
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Dates
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Enumeration Date | 12/29/2022
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 3311 S HIGHWAY 27 STE 4
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City | SOMERSET
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State | KY
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Zip | 42501-3179
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Country | US
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Telephone | 606-875-6403
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SLAGLE LN
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City | BRONSTON
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State | KY
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Zip | 42518-9583
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Country | US
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Telephone | 606-875-6403
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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 | 280937
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License Number State | KY
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