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Individual

FANIX BANNISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 N KROHN PL, SIOUX FALLS, SD 57103-1815
(605) 331-0588
Mailing address
7900 E ARROWHEAD PKWY APT 425, SIOUX FALLS, SD 57110-7027
(954) 501-3066

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT11975
SD

Other

Enumeration date
10/03/2023
Last updated
10/03/2023
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