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General NPI Number Information
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NPI Number | 1497465199
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Entity Type | Individual
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Provider Name | JENA BITTICKS-ASLTON
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Gender | Female
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 4915 HIGH POINT RD STE H
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City | GREENSBORO
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State | NC
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Zip | 27407-5311
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Country | US
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Telephone | 336-560-4860
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 PEPPER HILL RD
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City | GREENSBORO
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State | NC
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Zip | 27407-4042
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Country | US
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Telephone | 336-209-5062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 19342
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License Number State | NC
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