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General NPI Number Information
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NPI Number | 1285118133
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Entity Type | Organization
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Legal Business Name | AN ANGELS TOUCH BODYWORKS, LLC
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 607 HARKRIDER ST STE 5
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City | CONWAY
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State | AR
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Zip | 72032-5692
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Country | US
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Telephone | 501-259-5727
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Fax |
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Provider Business Mailing Address
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Address Line | 1645 CHURCHILL DR
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City | CONWAY
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State | AR
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Zip | 72034-6496
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Country | US
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Telephone | 501-259-5727
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Fax |
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Authorized Official
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Title or Position | MASTER MASSAGE THERAPIST/OWNER
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Name | LEA RILEY
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Credential | MMT
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Telephone | 501-259-5727
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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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