Provider Demographics
NPI:1801030143
Name:KANE, DANIEL P (NCTMB, LMT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:KANE
Suffix:
Gender:M
Credentials:NCTMB, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MONUMENTAL CIR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-8919
Mailing Address - Country:US
Mailing Address - Phone:775-233-8404
Mailing Address - Fax:
Practice Address - Street 1:155 MONUMENTAL CIR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-8919
Practice Address - Country:US
Practice Address - Phone:775-233-8404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT#3138225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist