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Individual
MRS. SHIRLEY JEAN DOTTS
Active
Individual
MRS. SHIRLEY JEAN DOTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED MEDICAL BIL
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
MSG002778
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12320555
NOT FOR MEDICARE
PA
05
—
1487922142
—
PA
05
—
1538458674
—
PA
Enumeration date
02/22/2020
Last updated
02/22/2020
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