Provider Demographics
NPI:1669016762
Name:THUNE, JEANNE (LMT, BCTMB, CHTP/I)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:THUNE
Suffix:
Gender:F
Credentials:LMT, BCTMB, CHTP/I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48153 334TH ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:SD
Mailing Address - Zip Code:57038-6837
Mailing Address - Country:US
Mailing Address - Phone:712-635-4301
Mailing Address - Fax:
Practice Address - Street 1:370 W ANCHOR DR STE 217
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5153
Practice Address - Country:US
Practice Address - Phone:712-635-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3221225700000X
IA072397225700000X
SDMT10205225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist