Organization Name: | KRISTINE ISHAM INC |
NPI Number: | 1144463852 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTINE DYAN ISHAM (OWNER) |
Mailing Address: | 709 Sebastian Blvd Ste G Sebastian |
State: | FL US |
Postal Code: | 329588704 |
Phone Number: | 7722289638 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2009 |
NPI Last Update Date: | 04/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |