Doctor Name: | WYNEMA INGERSOLL CHILIANIS |
NPI Number: | 1396175030 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 35896 |
Business Practice Address: | 200 S Townsend Ave Suite F Montrose, CO - 814014256 |
Business Phone Number: | 9704178840 |
Business Fax Number: | |
Mailing Address: | 200 S Townsend Ave, Suite F MONTROSE |
State: | CO |
Postal Code: | 814014256 |
Phone Number: | 9704178840 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2013 |
NPI Last Update Date: | 01/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 35896 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
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. |