Healthcare Provider Details
I. General information
NPI: 1831908367
Provider Name (Legal Business Name): ORO VALLEY MEDICAL MASSAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9950 N WILD CREEK DR
ORO VALLEY AZ
85742-8400
US
IV. Provider business mailing address
9950 N WILD CREEK DR
ORO VALLEY AZ
85742-8400
US
V. Phone/Fax
- Phone: 520-403-0025
- Fax:
- Phone: 520-403-0025
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRANDY
C
PATTERSON
Title or Position: OWNER/MASSAGE THERAPISTS
Credential:
Phone: 520-403-0025