Healthcare Provider Details

I. General information

NPI: 1467836072
Provider Name (Legal Business Name): THAI-ME SPA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 CENTRAL AVE STE D
HOT SPRINGS AR
71913-5715
US

IV. Provider business mailing address

5001 CENTRAL AVE STE D
HOT SPRINGS AR
71913-5715
US

V. Phone/Fax

Practice location:
  • Phone: 501-520-4772
  • Fax:
Mailing address:
  • Phone: 501-520-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number4938
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number4938
License Number StateAR

VIII. Authorized Official

Name: AMY THOMAS
Title or Position: PRESIDENT
Credential:
Phone: 501-318-4888