NPI Code Details Logo

NPI 1710842919

NPI 1710842919 : KODIE LYNN TOMASZKIEWICZ LMT : EAST MOLINE, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1710842919
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KODIE LYNN TOMASZKIEWICZ LMT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/19/2025
-----------------------------------------------------
    Last Update Date     |    12/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1304 18TH ST 
-----------------------------------------------------
    City                 |    EAST MOLINE
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    61244-1436
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    563-639-2197
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1304 18TH ST 
-----------------------------------------------------
    City                 |    EAST MOLINE
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    61244-1436
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    563-639-2197
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225700000X
-----------------------------------------------------
    Taxonomy Name        |    Massage Therapist
-----------------------------------------------------
    License Number       |    227.024240
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.