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General NPI Number Information
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NPI Number | 1104483197
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Entity Type | Organization
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Legal Business Name | HT MASSAGE THERAPY
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Dates
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Enumeration Date | 05/24/2019
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Last Update Date | 05/24/2019
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Provider Practice Location Address
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Address Line | 3615 W 57TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-2709
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Country | US
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Telephone | 605-370-1894
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Fax |
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Provider Business Mailing Address
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Address Line | 7301 S VALENCIA DR
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City | SIOUX FALLS
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State | SD
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Zip | 57108-1513
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Country | US
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Telephone | 605-254-0488
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | PAUL THRONSON
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Credential |
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Telephone | 605-254-0488
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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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