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General NPI Number Information
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NPI Number | 1558879387
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Entity Type | Organization
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Legal Business Name | LYMPHEDEMA THERAPY SPECIALISTS
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 01/15/2018
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Provider Practice Location Address
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Address Line | 6108 S LYNCREST AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57108-2560
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Country | US
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Telephone | 605-610-7995
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Fax |
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Provider Business Mailing Address
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Address Line | 6108 S LYNCREST AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57108-2560
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Country | US
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Telephone | 605-610-7995
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Fax |
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Authorized Official
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Title or Position | OWNER, CERTIFIED LYMPHEDEMA THERAPI
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Name | MS. CARRIE M LANGSTON
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Credential | CLT, LMT
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Telephone | 605-610-7995
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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 | MT11131
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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