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General NPI Number Information
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NPI Number | 1144805185
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Entity Type | Organization
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Legal Business Name | BODY HARMONY CORRECTIVE MASSAGE AND SPA
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 821 SW ALSBURY BLVD UNIT B
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City | BURLESON
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State | TX
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Zip | 76028-4090
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Country | US
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Telephone | 682-207-6150
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 MOCKINGBIRD CIR
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City | CLEBURNE
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State | TX
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Zip | 76031-7853
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Country | US
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Telephone | 817-690-9967
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MR. CANEN RAY SCOTT
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Credential | MT
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Telephone | 817-690-9967
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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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