Individual
MRS. DEIDRE JOY BANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1913 M ST, BELLEVILLE, KS 66935-2238
(785) 955-2233
Mailing address
205 BEACH ST, CUBA, KS 66940-3000
(785) 955-2233
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3225
NE
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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