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General NPI Number Information
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NPI Number | 1790321909
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Entity Type | Individual
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Provider Name | CELESTE KAUFMAN LMT
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Gender | Female
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 19116 N COLONNADE WAY
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City | SURPRISE
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State | AZ
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Zip | 85374-7223
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Country | US
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Telephone | 602-397-2199
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Fax |
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Provider Business Mailing Address
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Address Line | 19082 N R H JOHNSON BLVD STE F
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-4482
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Country | US
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Telephone | 602-397-2199
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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 | 22555
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License Number State | AZ
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