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General NPI Number Information
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NPI Number | 1912162736
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Entity Type | Organization
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Legal Business Name | KA-NAN ENTERPRISES
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 400 N SECOND ST
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City | HALIFAX
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State | PA
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Zip | 17032
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Country | US
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Telephone | 717-896-8626
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 618
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City | HALIFAX
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State | PA
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Zip | 17032-0618
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Country | US
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Telephone | 717-896-8626
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | NANCY M STICKNEY
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Credential | CMT
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Telephone | 717-896-8626
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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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