Healthcare Provider Details

I. General information

NPI: 1558794297
Provider Name (Legal Business Name): ROYAL TREATMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N ST SW APT 420
WASHINGTON DC
20024-3525
US

IV. Provider business mailing address

203 N ST SW APT 420
WASHINGTON DC
20024-3525
US

V. Phone/Fax

Practice location:
  • Phone: 202-412-7444
  • Fax:
Mailing address:
  • Phone: 202-412-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberMT1511
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0019010788
License Number StateVA

VIII. Authorized Official

Name: MR. CHARLES LEWIS PATTON III
Title or Position: OWNER, LICENSED MASSAGE THERAPIST
Credential: LMT, NCTMB
Phone: 202-412-7444