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General NPI Number Information
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NPI Number | 1164613972
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Entity Type | Organization
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Legal Business Name | EVER WELL THERAPEUTIC MASSAGE SERVICES
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 132 S NORTHWEST HWY STE 105
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City | BARRINGTON
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State | IL
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Zip | 60010-6324
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Country | US
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Telephone | 847-830-6414
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Fax |
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Provider Business Mailing Address
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Address Line | 34783 N GERBERDING AVE
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City | INGLESIDE
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State | IL
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Zip | 60041-9571
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Country | US
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Telephone | 847-830-6414
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LINDA J CLIFFORD
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Credential |
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Telephone | 847-830-6414
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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 | IL
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