Healthcare Provider Details

I. General information

NPI: 1497586267
Provider Name (Legal Business Name): EARTHLY ESSENCE MOBILE MASSAGE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 S ACADEMY ST
LINCOLNTON NC
28092-2714
US

IV. Provider business mailing address

207 S ACADEMY ST
LINCOLNTON NC
28092-2714
US

V. Phone/Fax

Practice location:
  • Phone: 336-448-3893
  • Fax:
Mailing address:
  • Phone: 336-448-3893
  • 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 Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: HANNAH DANIELLE BROWN
Title or Position: OWNER
Credential:
Phone: 828-228-9014