Healthcare Provider Details

I. General information

NPI: 1083836654
Provider Name (Legal Business Name): ALMOST HEAVEN THERAPEUTIC MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1436 GREENBRIER STREET
CHARLESTON WV
25311
US

IV. Provider business mailing address

1436 GREENBRIER STREET
CHARLESTON WV
25311
US

V. Phone/Fax

Practice location:
  • Phone: 304-720-3823
  • Fax:
Mailing address:
  • Phone: 304-720-3823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBRA PRICE
Title or Position: OWNER
Credential: LMT
Phone: 304-720-3823