Doctor Name: | DENNIS QUENTIN VENNER |
NPI Number: | 1336382357 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MT005335 |
Business Practice Address: | 5908 Fairburn Rd Ste C Douglasville, GA - 301342303 |
Business Phone Number: | 4044029985 |
Business Fax Number: | |
Mailing Address: | Po Box 185, LITHIA SPRINGS |
State: | GA |
Postal Code: | 301220185 |
Phone Number: | 4048951499 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2009 |
NPI Last Update Date: | 04/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT005335 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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. |