Provider Demographics
NPI:1427504257
Name:MESSIMER, KILEE (LMT, MMP)
Entity type:Individual
Prefix:
First Name:KILEE
Middle Name:
Last Name:MESSIMER
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 INDUSTRIAL BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7969
Mailing Address - Country:US
Mailing Address - Phone:605-939-8559
Mailing Address - Fax:
Practice Address - Street 1:1500 INDUSTRIAL BLVD STE 207
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7969
Practice Address - Country:US
Practice Address - Phone:605-939-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101900225700000X
TXMT134047225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist