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General NPI Number Information
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NPI Number | 1568288868
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Entity Type | Organization
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Legal Business Name | DESERT GEMINI PLLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 807 S AUBURN ST STE 4
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City | KENNEWICK
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State | WA
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Zip | 99336-5661
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Country | US
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Telephone | 509-492-2207
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Fax |
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Provider Business Mailing Address
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Address Line | 1124 E 23RD AVE
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City | KENNEWICK
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State | WA
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Zip | 99337-5523
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Country | US
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Telephone | 509-307-8887
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRICIA DAVIS
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Credential | LMT
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Telephone | 509-307-8887
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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 |
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License Number State |
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