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General NPI Number Information
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NPI Number | 1548412547
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Entity Type | Individual
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Provider Name | DORA DELAINE-WINTER FURLONG LMT, NCTMB
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 401 GALAXIE AVE
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2078
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Country | US
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Telephone | 816-884-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 121 E REMINGTON TER
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City | RAYMORE
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State | MO
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Zip | 64083-8538
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Country | US
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Telephone | 816-322-3055
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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 | 2007009415
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License Number State | MO
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