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General NPI Number Information
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NPI Number | 1215281399
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Entity Type | Organization
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Legal Business Name | HAYES THERAPEUTIC MASSAGE CENTER
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 2961 GEORGE WASHINGTON MEMORIAL HIGHWAY
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City | HAYES
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State | VA
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Zip | 23072-3402
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Country | US
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Telephone | 804-642-2100
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Fax | 804-642-5895
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Provider Business Mailing Address
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Address Line | 2961 GEORGE WASHINGTON MEMORIAL HIGHWAY
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City | HAYES
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State | VA
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Zip | 23072-3402
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Country | US
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Telephone | 804-642-2100
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Fax | 804-642-5895
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. GERLINDE M STEVENS
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Credential |
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Telephone | 804-642-2100
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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 | 0019000113
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License Number State | VA
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