LESLIE A DETIENNE (NPI# 1760640759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760640759 |
| Entity Type | Individual |
| Full Name | LESLIE A DETIENNE |
| Practice Address |
5934 Us Highway 6 Portage IN 46368-4946 |
| Mailing Address |
577 Sienna Ave Portage IN 46368-2560 |
| Practice Telephone | 2197627136 |
| Mailing Telephone | 2198400572 |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-05-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5934 US HIGHWAY 6 |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-4946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467583591 | Rohe Therapy Inc. | Physical Therapist | 5934 Us Highway 6, Portage, IN 46368-4946 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| 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 |
|---|---|---|---|---|
| 1356867337 | Thomas Emery Snyder | Massage Therapist | 210 E Centre Street, Portage, MI 49002-4900 | 2017-08-21 |
| 1518414788 | Laura Kim Rothwell | Massage Therapist | 1601 W Centre Ave, Suite 202, Portage, MI 49024-5396 | 2016-09-06 |
| 1952701393 | Dania Vander Meer | Massage Therapist | 5080 Lovers Ln Ste C, Portage, MI 49002-1570 | 2014-09-03 |
| 1316240609 | Maureen Margaret Moore | Massage Therapist | 1525 Greenview Ave, Portage, MI 49024-3322 | 2010-12-08 |
| 1720393515 | Kelly Denise Mclean | Massage Therapist | 7070 Austrian Pine Way, #4, Portage, MI 49024-3972 | 2010-08-17 |
| 1154969343 | Xinping Zhang | Massage Therapist | 2939 New Pinery Rd, Portage, WI 53901-9226 | 2019-12-18 |
| 1598316721 | Savannah Marie Stepan | Massage Therapist | 1125 E Milham Ave, Portage, MI 49002-3096 | 2019-09-29 |
| 1891278651 | Tami Coleen Stingley | Massage Therapist | 6126 Lovers Ln, Portage, MI 49002-3026 | 2018-09-07 |
| 1659588077 | Bryan Huey | Massage Therapist | 8827 Portage Rd, Portage, MI 49002-6415 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316853 | Tanika Scott | Massage Therapist | 914 Field St, Hammond, IN 46320-2536 | 2020-11-06 |
| 1629677604 | Dameta Diane Williams | Massage Therapist | 3525 Lake Ave, Fort Wayne, IN 46805-5599 | 2020-10-21 |
| 1962000836 | Chelsea Rae Mathews | Massage Therapist | 718 Adams St Ste D, Carmel, IN 46032-7594 | 2020-10-13 |
| 1154938330 | Jason Anderson | Massage Therapist | 1621 W Lawrence Dr, Scottsburg, IN 47170-6808 | 2020-09-30 |
| 1689281297 | Amanda Joy Smith | Massage Therapist | 4915 Rue Vallee Apt 89, Indianapolis, IN 46227-6660 | 2020-09-28 |
| 1447867114 | Tricia M Love | Massage Therapist | 4755 Highway 31 E Unit B, Clarksville, IN 47129-9220 | 2020-09-28 |
| 1750997912 | Steven W Spalding | Massage Therapist | 4755 Us-31 East, Clarksville, IN 47129 | 2020-09-22 |
| 1154937837 | Andrenique Coleman | Massage Therapist | 815 Hardin Blvd Apt C, Indianapolis, IN 46241-1987 | 2020-09-18 |
| 1245845833 | Ashley Nicole Bennett | Massage Therapist | 139 S 5th St, Richmond, IN 47374-4222 | 2020-09-10 |
| 1255944203 | Julia Piner | Massage Therapist | 303 S Delaware St, Indianapolis, IN 46204-3747 | 2020-08-28 |
| Find all providers with the same taxonomy | ||||
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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.