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NPI 1558870980

NPI 1558870980 : DENISE ANN ESTES LMT : SAEGERTOWN, PA

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General NPI Number Information
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    NPI Number           |    1558870980
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    Entity Type          |    Individual 
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    Provider Name        |    DENISE ANN ESTES LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/28/2017
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    179 BROAD ST P O BOX 475
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    City                 |    SAEGERTOWN
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    State                |    PA
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    Zip                  |    16433
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    Country              |    US
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    Telephone            |    814-573-1977
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 475 
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    City                 |    SAEGERTOWN
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    State                |    PA
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    Zip                  |    16433-0475
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    Country              |    US
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    Telephone            |    814-573-1977
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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       |    MSG003048
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    License Number State |    PA
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