Doctor Name: | MS. CONNIE QUEZADA |
NPI Number: | 1528377207 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.AC |
License Number: | MT038682 |
Business Practice Address: | 3004 Medical Arts St Austin, TX - 787053305 |
Business Phone Number: | 5122361141 |
Business Fax Number: | 5122361141 |
Mailing Address: | 3004 Medical Arts St, AUSTIN |
State: | TX |
Postal Code: | 787053305 |
Phone Number: | 5122361141 |
Fax Number: | 5122361141 |
NPI Enumeration Date: | 09/29/2010 |
NPI Last Update Date: | 10/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT038682 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
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. |