Provider Demographics
NPI:1831518851
Name:HARTMAN, DESIREE (CMT)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:DESIE
Other - Middle Name:
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMT
Mailing Address - Street 1:49346 ROAD 426 STE 1
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-9016
Mailing Address - Country:US
Mailing Address - Phone:559-760-0378
Mailing Address - Fax:559-658-5710
Practice Address - Street 1:49346 ROAD 426 STE 1
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-9016
Practice Address - Country:US
Practice Address - Phone:559-760-0378
Practice Address - Fax:559-658-5710
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist