Provider Demographics
NPI:1063586204
Name:HARTMAN, JOANI K (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:JOANI
Middle Name:K
Last Name:HARTMAN
Suffix:
Gender:F
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 1:18531 TARRAGON WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2026
Mailing Address - Country:US
Mailing Address - Phone:301-540-8091
Mailing Address - Fax:
Practice Address - Street 1:18531 TARRAGON WAY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2026
Practice Address - Country:US
Practice Address - Phone:301-540-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM00065171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor