Healthcare Provider Details

I. General information

NPI: 1285877241
Provider Name (Legal Business Name): HEALING TOUCH MASSAGE THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 VICTORIA STREET
WILLIAMSON WV
25661
US

IV. Provider business mailing address

PO BOX 405
WILLIAMSON WV
25661-0405
US

V. Phone/Fax

Practice location:
  • Phone: 304-235-1444
  • Fax: 304-235-1444
Mailing address:
  • Phone: 304-235-1444
  • Fax: 304-235-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2005-1726
License Number StateWV

VIII. Authorized Official

Name: MS. TERRESSA YAVONNE EVANS
Title or Position: PRESIDENT
Credential: LMT
Phone: 304-235-1444