MEDICARE: DENISE LYNNE SKINNER MASSAGE THERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	225700000X	OTHER	TX	MASSAGE THERAPY

General Provider Information

NPI Number	:	1033819578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE LYNNE SKINNER MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	3019 LASSES BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-4127
Country	:	US
Telephone Number	:	210-441-2086
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 N ALAMO ST STE 2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-1813
Country	:	US
Telephone Number	:	210-441-2086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2023
Last Update Date	:	03/03/2023

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Directions to “ DENISE LYNNE SKINNER MASSAGE THERAPIST” Practice Location

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