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General NPI Number Information
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NPI Number | 1417482076
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Entity Type | Organization
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Legal Business Name | RALSTON CARE, LLC
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 5969 E BROAD ST SUITE 304
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City | COLUMBUS
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State | OH
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Zip | 43213-1546
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Country | US
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Telephone | 614-321-2036
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Fax |
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Provider Business Mailing Address
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Address Line | 7616 S OAKBROOK DR
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-7202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT W HENRY
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Credential | LMT
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Telephone | 614-507-9597
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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 | 33023421
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License Number State | OH
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