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General NPI Number Information
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NPI Number | 1356814206
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Entity Type | Organization
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Legal Business Name | TRANQUIL MEDICAL MASSAGE, PLLC
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 3246 PRESTON RD STE 300
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City | FRISCO
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State | TX
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Zip | 75034-8075
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Country | US
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Telephone | 469-362-6669
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Fax |
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Provider Business Mailing Address
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Address Line | 3246 PRESTON RD STE 300
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City | FRISCO
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State | TX
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Zip | 75034-8075
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Country | US
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Telephone | 469-362-6669
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROBERT GROYSMAN
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Credential | MD
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Telephone | 469-600-6241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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