Individual
MADELYNNE FIMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT/MMP, OTA
Contact information
Practice address
8057 WHITEHART ST, FRISCO, TX 75035-3166
(469) 406-9123
Mailing address
8057 WHITEHART ST, FRISCO, TX 75035-3166
(469) 406-9123
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT107685
TX
174400000X
Specialist
MT107685
TX
225400000X
Rehabilitation Practitioner
MT107685
TX
225700000X
Massage Therapist
Primary
MT107685
TX
251E00000X
Home Health Agency
MT107685
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT107685
MASSAGE THERAPY LICENSE
TX
Enumeration date
12/28/2018
Last updated
12/28/2018
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