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General NPI Number Information
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NPI Number | 1417420605
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Entity Type | Organization
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Legal Business Name | COMPLETE HEALTH MASSAGE
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 2201 S W S YOUNG DR
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City | KILLEEN
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State | TX
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Zip | 76543-5317
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Country | US
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Telephone | 254-247-7075
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 PIRTLE DR
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City | SALADO
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State | TX
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Zip | 76571-6195
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Country | US
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Telephone | 254-247-7075
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TEANNA KIM CASTEEL
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Credential | LMT,MMP
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Telephone | 254-247-7075
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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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