Healthcare Provider Details

I. General information

NPI: 1083349351
Provider Name (Legal Business Name): NATURES REMEDY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 08/28/2022
Certification Date: 08/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E MAIN ST
NORTH MANCHESTER IN
46962-1822
US

IV. Provider business mailing address

121 E MAIN ST
NORTH MANCHESTER IN
46962-1822
US

V. Phone/Fax

Practice location:
  • Phone: 260-306-3057
  • Fax:
Mailing address:
  • Phone: 260-306-3057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRYSTAL PRESL
Title or Position: OPERATING MANAGER/MEDICAL MASSAGE
Credential: LMT MMP
Phone: 260-306-3057