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General NPI Number Information
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NPI Number | 1467174813
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Entity Type | Organization
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Legal Business Name | FLOW LIKE WATER MASSAGE PLLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 214 NORTH GLOVER ST.
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City | TWISP
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State | WA
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Zip | 98856
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Country | US
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Telephone | 509-668-1319
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 998
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City | TWISP
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State | WA
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Zip | 98856-0998
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Country | US
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Telephone | 509-668-1319
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Fax |
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Authorized Official
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Title or Position | OWNER/LMT
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Name | MR. RENE SOPERANEZ II
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Credential | LMT
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Telephone | 509-668-1319
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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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