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General NPI Number Information
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NPI Number | 1497178024
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Entity Type | Organization
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Legal Business Name | CHESTER COUNTY MASSAGE THERAPY
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 828 PAOLI PIKE
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City | WEST CHESTER
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State | PA
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Zip | 19380-4526
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Country | US
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Telephone | 484-678-9202
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1079
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-0428
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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 | CHRISTINE BURNETT
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Credential | LMT/CMT
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Telephone | 484-678-9202
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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 | MSG006134
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License Number State | PA
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