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General NPI Number Information
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NPI Number | 1265853444
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Entity Type | Organization
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Legal Business Name | HOLISTIC THERAPEUTIC KNEADS,INC
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Dates
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Enumeration Date | 12/14/2013
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Last Update Date | 12/14/2013
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Provider Practice Location Address
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Address Line | 2201 EASTCHESTER DR SUITE 101
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City | HIGH POINT
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State | NC
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Zip | 27265-1516
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Country | US
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Telephone | 336-355-8398
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Fax | 336-841-6984
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Provider Business Mailing Address
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Address Line | 2206 PORSHA LN
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City | HIGH POINT
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State | NC
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Zip | 27265-1469
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Country | US
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Telephone | 336-307-9090
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Fax | 336-841-6984
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Authorized Official
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Title or Position | OWNER
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Name | MS. GRETA STACHES
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Credential | AM, LMBT, MMP
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Telephone | 336-307-9090
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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 | 11850
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License Number State | NC
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