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General NPI Number Information
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NPI Number | 1235990672
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Entity Type | Organization
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Legal Business Name | RESTORE MASSAGE
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 8000 W INTERSTATE 10 STE 673
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City | SAN ANTONIO
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State | TX
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Zip | 78230-3868
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Country | US
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Telephone | 210-689-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 615 CLAUDE W BLACK
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City | SAN ANTONIO
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State | TX
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Zip | 78203-1400
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Country | US
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Telephone | 210-689-2222
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Fax |
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Authorized Official
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Title or Position | MANAGING EMPLOYEE/ MASSAGE THERAPIS
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Name | ROSA DELIA VASQUEZ
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Credential | MTI ,MT
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Telephone | 210-689-2222
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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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