MEDICARE: DWAYNE THURMOND LMT,MCTMB,NCMA,CMCP

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	NVMT.3065	NV

General Provider Information

NPI Number	:	1841528882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DWAYNE THURMOND LMT,MCTMB,NCMA,CMCP

Provider Business Mailing Address
First Line	:	9353 W TWAIN AVE
Second Line	:	APT. 185
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6861
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 S RAINBOW BLVD
Second Line	:	STE. 21
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5362
Country	:	US
Telephone Number	:	702-880-4325
Fax Number	:	702-870-2889

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

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	03/22/2026

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