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General NPI Number Information
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NPI Number | 1063820538
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC MASSAGE GROUP AND EQUIPMENT
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 2504 E GLEN OAKS CIR
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City | WICHITA
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State | KS
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Zip | 67216-2215
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Country | US
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Telephone | 316-706-6965
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Fax |
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Provider Business Mailing Address
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Address Line | 10500 E BERKELEY SQUARE PKWY SUITE 102
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City | WICHITA
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State | KS
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Zip | 67206-6815
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Country | US
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Telephone | 316-706-6965
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JANET A KLOES
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Credential | MMP
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Telephone | 316-706-6965
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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 | KS
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