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General NPI Number Information
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NPI Number | 1316713373
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Entity Type | Organization
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Legal Business Name | ENDLESS HEALING HANDS MASSAGE LLC
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 714 LYNDON LN STE 5
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City | LYNDON
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State | KY
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Zip | 40222-4643
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Country | US
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Telephone | 502-712-2497
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Fax |
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Provider Business Mailing Address
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Address Line | 714 LYNDON LN STE 5
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City | LYNDON
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State | KY
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Zip | 40222-4643
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Country | US
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Telephone | 502-712-2497
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Fax |
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Authorized Official
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Title or Position | MASSAGE
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Name | ANDREYA WALLKER
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Credential | L.M.T
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Telephone | 502-712-2497
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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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