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General NPI Number Information
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NPI Number | 1053890269
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Entity Type | Organization
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Legal Business Name | KEYSTONE BODY THERAPIES
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 1600 W CHANDLER BLVD STE 250
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City | CHANDLER
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State | AZ
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Zip | 85224-6162
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Country | US
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Telephone | 480-686-8647
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W CHANDLER BLVD STE 250
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City | CHANDLER
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State | AZ
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Zip | 85224-6162
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Country | US
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Telephone | 480-686-8647
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TATE HARDCASTLE
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Credential |
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Telephone | 480-686-8647
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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 | MT-22972
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-17566
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-22573
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-23770
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-23403
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License Number State | AZ
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Taxonomy #6
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-22184
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License Number State | AZ
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Taxonomy #7
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-19729
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License Number State | AZ
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Taxonomy #8
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-17560
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License Number State | AZ
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Taxonomy #9
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-24282
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License Number State | AZ
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Taxonomy #10
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-24731
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License Number State | AZ
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Taxonomy #11
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-06814
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License Number State | AZ
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