Doctor Name: | NICOLE SUSAN FERRIS |
NPI Number: | 1770828485 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.AC., LMT |
License Number: | 11906 |
Business Practice Address: | 1 Shalimar Dr Mount Vernon, OH - 430501977 |
Business Phone Number: | 7403922004 |
Business Fax Number: | 7403922004 |
Mailing Address: | 1 Shalimar Dr, MOUNT VERNON |
State: | OH |
Postal Code: | 430501977 |
Phone Number: | 7403922004 |
Fax Number: | 7403922004 |
NPI Enumeration Date: | 12/06/2012 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 11906 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
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. |