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General NPI Number Information
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NPI Number | 1417811381
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Entity Type | Organization
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Legal Business Name | WILSON THERAPEUTIC TOUCH LLC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1084 FLYNT DR STE 440
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City | FLOWOOD
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State | MS
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Zip | 39232-9736
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Country | US
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Telephone | 770-283-4643
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Fax |
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Provider Business Mailing Address
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Address Line | 117 TRAILBRIDGE WAY
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City | CANTON
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State | MS
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Zip | 39046-6063
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Country | US
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Telephone | 770-283-4643
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TORRIS WILSON
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Credential |
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Telephone | 770-283-4643
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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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