MR. TERRY LEE CRADDOCK L.M.T L.P.N. NPI 1164605549

NPI Information

NPI: 1164605549
Provider Name: MR. TERRY LEE CRADDOCK, L.M.T, L.P.N.
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
120 S MAIN ST
FARMER CITY, IL
ZIP 61842
Phone: (309) 824-4373
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MR. Terry Lee Craddock, L.M.T, L.P.N. is a massage therapist in Farmer City, IL. The provider is 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. MR. Terry Lee Craddock, L.M.T, L.P.N. NPI is 1164605549. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

120 S MAIN ST
FARMER CITY, IL
ZIP 61842-454
Phone: (309) 824-4373

The enumeration date for this NPI number is 12/9/2007 and was last updated on 1/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist			ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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