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General NPI Number Information
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NPI Number | 1356245146
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Entity Type | Organization
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Legal Business Name | BLACK ONYX MOBILE MASSAGE, LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 7358 GARNERS FERRY RD STE 217
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City | COLUMBIA
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State | SC
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Zip | 29209-2262
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Country | US
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Telephone | 839-252-9337
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Fax |
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Provider Business Mailing Address
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Address Line | 7358 GARNERS FERRY RD STE 217
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City | COLUMBIA
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State | SC
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Zip | 29209-2262
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Country | US
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Telephone | 839-252-9337
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SKYELAH FORD
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Credential | LMT
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Telephone | 839-252-9337
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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 | NULL
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