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General NPI Number Information
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NPI Number | 1134590102
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Entity Type | Organization
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Legal Business Name | ADRIAN KING MASSAGE AND YOGA
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 519 S 9TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19147-1331
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Country | US
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Telephone | 267-229-7323
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Fax |
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Provider Business Mailing Address
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Address Line | 519 S 9TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19147-1331
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Country | US
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Telephone | 267-229-7323
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ADRIAN SAMUEL KING
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Credential | LMT
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Telephone | 267-229-7323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MSG001135
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License Number State | PA
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