NPI 1013543719

Adrian Lamar Prophet, LMT

Practitioner Massage Therapist Edmond, OK

Practice location

Address: 115 W 15th St STE B, Edmond, OK 73013-3642
Phone: (405) 535-6339
Mailing address: 417 Madison CT, Moore, OK 73160-6744

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 182962 (OK)

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Registry record

NPI: 1013543719
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Mar 2020
Record last updated: 14 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.