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General NPI Number Information
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NPI Number | 1013797810
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Entity Type | Organization
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Legal Business Name | REFLECTIONS MEDISPA, LLC
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 7104 NOVAS LNDG
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City | SELLERSBURG
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State | IN
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Zip | 47172-1899
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Country | US
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Telephone | 502-299-4256
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Fax | 812-203-5678
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Provider Business Mailing Address
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Address Line | 8129 HARMONY WAY
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City | CHARLESTOWN
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State | IN
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Zip | 47111-1302
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Country | US
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Telephone | 812-590-3800
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Fax | 812-203-5678
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE BROOKS-TATE
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Credential |
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Telephone | 502-299-4256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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