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General NPI Number Information
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NPI Number | 1396994059
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Entity Type | Organization
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Legal Business Name | A BETTER MASSAGE CLINC INC
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 2177 KINGSLEY AVE SUITE 11
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City | ORANGE PARK
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State | FL
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Zip | 32073-5199
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Country | US
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Telephone | 904-298-0830
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Fax |
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Provider Business Mailing Address
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Address Line | 2177 KINGSLEY AVE SUITE 11
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City | ORANGE PARK
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State | FL
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Zip | 32073-5132
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Country | US
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Telephone | 904-298-0830
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RICHARD P SILVIA
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Credential |
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Telephone | 904-298-0830
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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 | MM19329
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License Number State | FL
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