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General NPI Number Information
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NPI Number | 1194216309
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Entity Type | Organization
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Legal Business Name | TRANQUILITY MASSAGE & SPA LLC
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 1603 BOONE ST
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City | LEESVILLE
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State | LA
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Zip | 71446-5270
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Country | US
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Telephone | 337-353-6086
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Fax | 337-397-4622
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Provider Business Mailing Address
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Address Line | 1603 BOONE ST
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City | LEESVILLE
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State | LA
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Zip | 71446-5270
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Country | US
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Telephone | 337-353-6086
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Fax | 337-397-4622
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Authorized Official
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Title or Position | OWNER
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Name | MARILYN MANLEY
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Credential |
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Telephone | 337-353-6086
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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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