Provider Demographics
NPI:1427213602
Name:SETTLE-KENEFICK, PEGGY FLYNN (BS, LMT, CMT)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:FLYNN
Last Name:SETTLE-KENEFICK
Suffix:
Gender:F
Credentials:BS, LMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 6TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-1461
Mailing Address - Country:US
Mailing Address - Phone:605-692-8050
Mailing Address - Fax:
Practice Address - Street 1:521 6TH ST STE 102
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1461
Practice Address - Country:US
Practice Address - Phone:605-692-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD141174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD141OtherSTATE MASSAGE THERAPY LICENSE - SOUTH DAKOTA
CO126871OtherABMP (AMERICAN BODYWORK & MASSAGE PRACTIONERS)