DALLAS BRYANT (NPI# 1396136388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396136388 |
| Entity Type | Individual |
| Full Name | DALLAS BRYANT |
| Credential | LMT |
| Practice Address |
813 E Gate Dr Ste B Mount Laurel NJ 08054-1238 |
| Mailing Address |
207 Nathaniel Ave Cherry Hill NJ 08003-1528 |
| Practice Telephone | 2158731168 |
| Mailing Telephone | 2158731168 |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 18KT00436200 | NJ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
813 E GATE DR STE B |
| City | MOUNT LAUREL |
| State | NJ |
| Zip Code | 08054-1238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881742369 | Integrative Medicine and Biofeedback Clinic | Specialist/Technologist, Other | 813 E Gate Dr Ste B, Mount Laurel, NJ 08054-1238 | 2007-01-08 |
| 1740502194 | Cheruvathoor Samuel Verghese | Counselor | 813 E Gate Dr Ste B, Mount Laurel, NJ 08054-1238 | 2010-02-25 |
| 1609070465 | Autonomic Clinical Services | Family Medicine | 813 E Gate Dr Ste B, Mount Laurel, NJ 08054-1238 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837267 | Samantha Leafey | Behavior Technician | 800 Birchfield Dr., 801, Mount Laurel, NJ 08054 | 2019-12-04 |
| 1306403522 | A-1 Support Coordination Nj | Case Management | 1504 Larchmont Place, Mount Laurel, NJ 08054 | 2019-05-22 |
| 1285129080 | Lincoln Healthcare of New Jersey, LLC | Home Health | 309 Fellowship Rd Ste 100, Mount Laurel, NJ 08054 | 2018-06-25 |
| 1295238400 | Verus Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 200 E Park Dr Ste 600a, Mount Laurel, NJ 08054 | 2018-03-14 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1750893954 | Tishanna D Majette Phd Corporation | Psychologist | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054 | 2017-10-27 |
| 1700304706 | Arc of Camden County Essex Lane Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5320 Essex Lane, Mt. Laurel, NJ 08054 | 2017-08-30 |
| 1417472861 | Maggie Garin | Dietitian, Registered | 15000 Midlantic Avenue, Suite 101, Mount Laurel, NJ 08054 | 2017-08-07 |
| 1891225363 | New Jersey Lice Treatment LLC | Technician, Other | 500 Birchfield Dr, Suite 503-a, Mount Laurel, NJ 08054 | 2017-06-15 |
| 1225563927 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 761 Grant Ave, Mt Laurel, NJ 08054 | 2017-05-01 |
| Find all providers in zip 08054 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699562 | Nichole Elyse Echevarria | Massage Therapist | 184 Manhattan Ave, Teaneck, NJ 07666-6110 | 2020-11-07 |
| 1124629258 | Lisseth Fernandez | Massage Therapist | 87 E Spring Valley Ave, Maywood, NJ 07607-2122 | 2020-11-04 |
| 1316547052 | Prescott Veere Murphy Iv | Massage Therapist | 232 Longwood Dr, Manalapan, NJ 07726-3851 | 2020-10-30 |
| 1164022992 | Elise Warshavsky | Massage Therapist | 80 Pompton Ave Ste 304, Verona, NJ 07044-2913 | 2020-10-30 |
| 1841899556 | Mina Kwon | Massage Therapist | 191 Lakeview Ave, Leonia, NJ 07605-1541 | 2020-10-22 |
| 1174121016 | Paul Manzella | Massage Therapist | 18 Faner Rd, Midland Park, NJ 07432-1746 | 2020-10-13 |
| 1801494844 | Kelly Cannon | Massage Therapist | 83 Brokaw Blvd, Plainfield, NJ 07063-1067 | 2020-10-13 |
| 1659979896 | Maria Fernanda Zuniga | Massage Therapist | 612 Helena Ave, Cherry Hill, NJ 08002-2945 | 2020-10-10 |
| 1477150647 | Quienne White | Massage Therapist | 3150 Rte 22 Ste 6, Branchburg, NJ 08876-3595 | 2020-10-01 |
| 1124635545 | Michael Ciardulli Jr. | Massage Therapist | 174 Raab Ave, Bloomfield, NJ 07003-4521 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT LAUREL |
| Zip Code | 08054 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.