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General NPI Number Information
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NPI Number | 1316754161
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Entity Type | Organization
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Legal Business Name | PROSPER THERAPEUTIC WELLNESS
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2568 WATERBRIDGE WAY # 2562
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City | EVANSVILLE
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State | IN
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Zip | 47710-3200
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Country | US
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Telephone | 812-213-0184
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Fax |
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Provider Business Mailing Address
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Address Line | 1312 WOODBINE LN
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City | EVANSVILLE
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State | IN
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Zip | 47710-3872
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Country | US
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Telephone | 930-204-9982
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AARON BALDWIN
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Credential | LMT
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Telephone | 930-204-9982
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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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