PRAIRIE RIDGE ORTHOPEDIC NPI 1033718192

NPI Information

NPI: 1033718192
Provider Name: PRAIRIE RIDGE ORTHOPEDIC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Address:
1750 E COLBORN CAMP LN
NOBLE, IL
ZIP 62868
Phone: (618) 302-1703
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PRAIRIE RIDGE ORTHOPEDIC is a massage therapist in Noble, IL. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. PRAIRIE RIDGE ORTHOPEDIC NPI is 1033718192. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1750 E COLBORN CAMP LN
NOBLE, IL
ZIP 62868-348
Phone: (618) 302-1703

The provider's authorized official is Jody Hazel .
The authorized official title is Therapist and has the following contact phone number (618) 302-1703.

The enumeration date for this NPI number is 10/20/2020 and was last updated on 11/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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