Healthcare Provider Details

I. General information

NPI: 1417885880
Provider Name (Legal Business Name): HOSTLER HOLISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 CARPENTER FLETCHER RD STE 402
DURHAM NC
27713-2271
US

IV. Provider business mailing address

PO BOX 12282
DURHAM NC
27709-2282
US

V. Phone/Fax

Practice location:
  • Phone: 910-964-8190
  • Fax:
Mailing address:
  • Phone: 910-964-8190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: TERESA HOSTLER
Title or Position: MASSAGE THERAPIST
Credential: LMBT
Phone: 910-964-8190