Provider Demographics
NPI:1548405988
Name:BISHOP, DEANNA ROSE (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:ROSE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:260 N ROCK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2285
Mailing Address - Country:US
Mailing Address - Phone:316-807-4804
Mailing Address - Fax:316-440-6404
Practice Address - Street 1:260 N ROCK RD STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2285
Practice Address - Country:US
Practice Address - Phone:316-807-4804
Practice Address - Fax:316-440-6404
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist