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General NPI Number Information
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NPI Number | 1376015438
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Entity Type | Individual
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Provider Name | MADELYNNE FIMPLE LMT/MMP, OTA
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Gender | Female
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Dates
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Enumeration Date | 12/28/2018
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Last Update Date | 12/28/2018
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Provider Practice Location Address
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Address Line | 8057 WHITEHART ST
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City | FRISCO
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State | TX
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Zip | 75035-3166
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Country | US
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Telephone | 469-406-9123
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Fax |
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Provider Business Mailing Address
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Address Line | 8057 WHITEHART ST
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City | FRISCO
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State | TX
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Zip | 75035-3166
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Country | US
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Telephone | 469-406-9123
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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 | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | MT107685
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MT107685
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | MT107685
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | MT107685
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT107685
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License Number State | TX
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