Provider Demographics
NPI:1770317364
Name:HARTMAN UMPHRESS, DOROTHY FAY (LMT)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:FAY
Last Name:HARTMAN UMPHRESS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52537-1750
Mailing Address - Country:US
Mailing Address - Phone:641-208-6040
Mailing Address - Fax:
Practice Address - Street 1:108 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IA
Practice Address - Zip Code:52537-1750
Practice Address - Country:US
Practice Address - Phone:641-208-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088086225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty