Provider Demographics
NPI:1003971292
Name:EISINGER, SALLY M (CMT)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:M
Last Name:EISINGER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513-B SOLANO ST.
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:CA
Mailing Address - Zip Code:96035
Mailing Address - Country:US
Mailing Address - Phone:530-824-6860
Mailing Address - Fax:530-824-0698
Practice Address - Street 1:1513-B SOLANO ST.
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:CA
Practice Address - Zip Code:96021
Practice Address - Country:US
Practice Address - Phone:530-824-6860
Practice Address - Fax:530-824-0698
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist