Provider Demographics
NPI:1437470259
Name:DESKINS, DANA R (LMT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:R
Last Name:DESKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1772 MAPLE ACRES RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24739-7352
Mailing Address - Country:US
Mailing Address - Phone:304-910-3031
Mailing Address - Fax:
Practice Address - Street 1:1772 MAPLE ACRES RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24739
Practice Address - Country:US
Practice Address - Phone:304-910-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2002-1065225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist