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General NPI Number Information
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NPI Number | 1124316591
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Entity Type | Organization
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Legal Business Name | CLASSIC TOUCH MASSAGE, INC.
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 8177 GLADES RD SUITE 221
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City | BOCA RATON
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State | FL
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Zip | 33434-4071
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Country | US
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Telephone | 954-579-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 3821 WOODFIELD CT
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2238
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Country | US
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Telephone | 954-579-5599
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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 | MRS. JACKI YASIN
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Credential |
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Telephone | 954-687-7607
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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 | MA29786
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License Number State | FL
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