Healthcare Provider Details

I. General information

NPI: 1558271403
Provider Name (Legal Business Name): TIMELESS KNEADS WELLNESS MASSAGE & MORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 MOTELY DR
DILLON SC
29536-8214
US

IV. Provider business mailing address

1752 MOTELY DR
DILLON SC
29536-8214
US

V. Phone/Fax

Practice location:
  • Phone: 706-671-8320
  • Fax:
Mailing address:
  • Phone: 706-671-8320
  • 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: LATORYA FREDERICKA MANNING
Title or Position: OWNER
Credential: LMT
Phone: 706-671-8320