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General NPI Number Information
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NPI Number | 1316826530
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Entity Type | Organization
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Legal Business Name | GROUNDED BODYWORK BY MELISSA LLC
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 11450 ROJAS DR STE D20
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City | EL PASO
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State | TX
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Zip | 79936-6995
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Country | US
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Telephone | 928-358-8604
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Fax |
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Provider Business Mailing Address
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Address Line | 17498 BETTINA AVE
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City | EL PASO
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State | TX
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Zip | 79938-8721
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Country | US
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Telephone | 928-358-8604
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MELISSA BENNETT
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Credential | LMT
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Telephone | 928-358-8604
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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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