IndividualActive
Santisouk Prough, CMT
NPI 1306691449 · Nurse Massage Therapist (NMT) · Peoria, AZ
Provider details
- NPI number
- 1306691449
- Entity type
- Individual
- Primary specialty
- Nurse Massage Therapist (NMT)Nursing Service Providers
- Credential
- CMT
- Sex
- Female
- Sole proprietor
- Yes
- License
- MT (AZ)
Specialties & taxonomies
Nursing Service Providers
Practice location
8278 W Lake Pleasant Pkwy
Peoria, AZ 85382-7441
Phone: (510) 384-5817
Approximate (ZIP-level) locationGet directions
Mailing address
19401 N 15th Pl
Phoenix, AZ 85024-3625
Registry dates
- Enumerated
- 2024-04-22
- Last updated
- 2026-02-04
- Certified
- 2026-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.