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General NPI Number Information
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NPI Number | 1518621275
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Entity Type | Organization
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Legal Business Name | THE MASSAGE THERAPIST, PLLC
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 722 S DENTON TAP RD STE 290
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City | COPPELL
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State | TX
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Zip | 75019-4515
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Country | US
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Telephone | 682-433-6252
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 BAMBOO DR APT N106
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City | ARLINGTON
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State | TX
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Zip | 76006-5972
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Country | US
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Telephone | 682-433-6252
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | MS. MONICA LEWIS
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Credential | LMT
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Telephone | 682-433-6252
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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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