Provider Demographics
NPI:1477987584
Name:SHIRAZI, JOYCE MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIE
Last Name:SHIRAZI
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 1:2121 RICHMOND RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1206
Mailing Address - Country:US
Mailing Address - Phone:859-619-7359
Mailing Address - Fax:859-987-8371
Practice Address - Street 1:1529 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1437
Practice Address - Country:US
Practice Address - Phone:859-276-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0757225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist