Healthcare Provider Details

I. General information

NPI: 1023927035
Provider Name (Legal Business Name): KIASHUNTI LIMEHOUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MAIN ST
NEWBERRY SC
29108-3431
US

IV. Provider business mailing address

1302 JEFFERSON ST
NEWBERRY SC
29108-4324
US

V. Phone/Fax

Practice location:
  • Phone: 893-298-4388
  • Fax:
Mailing address:
  • Phone: 803-298-4388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13455
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: