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General NPI Number Information
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NPI Number | 1093352924
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Entity Type | Organization
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Legal Business Name | RESTORATION MIND BODY & SOLE
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 1995 PEPPERELL PKWY STE 5
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City | OPELIKA
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State | AL
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Zip | 36801-5460
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Country | US
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Telephone | 334-521-6080
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Fax |
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Provider Business Mailing Address
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Address Line | 1995 PEPPERELL PKWY STE 5
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City | OPELIKA
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State | AL
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Zip | 36801-5460
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Country | US
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Telephone | 334-521-6080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA T VINSON
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Credential | RN, MMT
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Telephone | 334-521-6080
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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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