Provider Demographics
NPI:1801190236
Name:ABDULRAHMAN, AMIN KASIM (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:AMIN
Middle Name:KASIM
Last Name:ABDULRAHMAN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 E MONTE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2046
Mailing Address - Country:US
Mailing Address - Phone:520-591-9418
Mailing Address - Fax:520-881-0485
Practice Address - Street 1:3415 E MONTE VISTA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2046
Practice Address - Country:US
Practice Address - Phone:520-591-9418
Practice Address - Fax:520-881-0485
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X, 174H00000X, 175M00000X, 225400000X, 226300000X
AZMT11778225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator
No175M00000XOther Service ProvidersMidwife, Lay
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist