NPI 1578253118

Nickey Dawn Colclasure, LMT

Practitioner Massage Therapist Bentonville, AR

Practice location

Address: 2711 SE I St STE 11, Bentonville, AR 72712-3209
Phone: (479) 256-2170
Mailing address: 813 S 28th St, Rogers, AR 72758-3915

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 7782 (AR)

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Registry record

NPI: 1578253118
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 May 2023
Record last updated: 8 May 2023

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.