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General NPI Number Information
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NPI Number | 1467756726
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Entity Type | Organization
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Legal Business Name | ANSHIN MASSAGE AND BODYWORK LLC
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 620 BABCOCK BLVD E SUITE 5
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City | DELANO
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State | MN
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Zip | 55328-8603
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Country | US
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Telephone | 763-807-6836
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 FOX ST
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City | DELANO
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State | MN
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Zip | 55328-8731
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Country | US
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Telephone | 763-807-6836
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIANA L JOHNSON
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Credential |
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Telephone | 763-807-6836
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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 | MN
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