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NPI Code Detail

MEDICARE: MS. SPRING MINES MASSAGE THERAPIST

MEDICARE: MS. SPRING MINES MASSAGE THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist1000306-519NV

General Provider Information

NPI Number : 1891820734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SPRING MINES MASSAGE THERAPIST
Provider Business Mailing Address
First Line : 4521 TABIC DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-2144
Country : US
Telephone Number : 702-300-1198
Fax Number :
Provider Business Practice Location Address
First Line : 4521 TABIC DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-2144
Country : US
Telephone Number : 702-300-1198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/08/2007

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Directions to “ MS. SPRING MINES MASSAGE THERAPIST” Practice Location

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