Provider Demographics
NPI:1184414468
Name:DECKMAN, BETH (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:DECKMAN
Suffix:
Gender:
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 1:581 TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4450
Mailing Address - Country:US
Mailing Address - Phone:480-619-3160
Mailing Address - Fax:
Practice Address - Street 1:581 TEMPLE DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4450
Practice Address - Country:US
Practice Address - Phone:480-619-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT50047225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist