Doctor Name: | MS. ELENA RAE STAMPS |
NPI Number: | 1578995015 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | 4915 |
Business Practice Address: | 923 College St Suite C Bowling Green, KY - 421012195 |
Business Phone Number: | 5028368895 |
Business Fax Number: | |
Mailing Address: | 1780 Patrick Way, Apt. #4 BOWLING GREEN |
State: | KY |
Postal Code: | 421044120 |
Phone Number: | 5028368895 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2013 |
NPI Last Update Date: | 08/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 4915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
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. |