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General NPI Number Information
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NPI Number | 1073309134
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Entity Type | Organization
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Legal Business Name | PASS ME KNOT MASSAGE LLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 2010 OLIVE RD
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City | AUGUSTA
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State | GA
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Zip | 30906-2056
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Country | US
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Telephone | 706-386-3390
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Fax | 706-305-9922
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Provider Business Mailing Address
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Address Line | 2010 OLIVE RD
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City | AUGUSTA
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State | GA
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Zip | 30906-2056
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Country | US
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Telephone | 706-386-3390
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Fax | 706-305-9922
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | MS. SABRINA DENISE LABORD
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Credential |
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Telephone | 706-962-2873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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