Doctor Name: | CARL HEDGES |
NPI Number: | 1962859835 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | MT123783 |
Business Practice Address: | 412 1/2 N Warren St Overton, TX - 756841116 |
Business Phone Number: | 9038085568 |
Business Fax Number: | |
Mailing Address: | 412 1/2 N Warren St, OVERTON |
State: | TX |
Postal Code: | 756841116 |
Phone Number: | 9038085568 |
Fax Number: | |
NPI Enumeration Date: | 05/19/2016 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT123783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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. |