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General NPI Number Information
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NPI Number | 1356690358
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Entity Type | Organization
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Legal Business Name | A BODY IN KNEAD, LLC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 10/07/2013
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Provider Practice Location Address
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Address Line | 263 STATE ST SUITE 6
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City | BANGOR
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State | ME
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Zip | 04401-5435
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Country | US
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Telephone | 207-989-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 263 STATE ST SUITE 6
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City | BANGOR
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State | ME
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Zip | 04401-5435
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Country | US
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Telephone | 207-989-7473
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Fax |
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Authorized Official
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Title or Position | OWNER/LMT/MA
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Name | MS. DAWN M DAY
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Credential | LMT
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Telephone | 207-989-7473
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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 | MT3748
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License Number State | ME
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