Individual provider · Type 1 NPI
Deidre M. Buckingham, PTA, LMT
Massage Therapist · Madison, WI
NPI number
1164582771
Active
Practice location
1915 Winnebago St
Madison, WI 53704-5305
Fax (608) 200-3270
Mailing address
727 Saint Johns Ave
Milton, WI 53563-1692
Other practice locations
- 4602 East Park Boulevard East Wing Mail Code AC10, Madison, WI 53792-0001 · (608) 262-9355
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapy Assistant | 225200000X | 1353-019 (WI) |
| Massage Therapist Primary | 225700000X | 724-146 (WI) |
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.
2 other providers at this address
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About NPI 1164582771
Deidre M. Buckingham, PTA, LMT's National Provider Identifier is 1164582771, issued on Dec 12, 2006. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Madison, WI. The record was last updated on Aug 18, 2021.