Healthcare Provider Details

I. General information

NPI: 1598676652
Provider Name (Legal Business Name): SANFORD THERAPEUTIC MASSAGE & BODYWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 COURT SQ STE A
SANFORD NC
27330-5677
US

IV. Provider business mailing address

5139 CARBONTON RD
SANFORD NC
27330-6352
US

V. Phone/Fax

Practice location:
  • Phone: 919-777-4940
  • Fax:
Mailing address:
  • Phone: 919-353-0144
  • 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: ALISIA R TRIPP
Title or Position: OWNER/LICENSED MASSAGE THERAPIST
Credential: LMBT
Phone: 919-353-0144