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General NPI Number Information
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NPI Number | 1588988638
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Entity Type | Organization
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Legal Business Name | PLATINUM ELEMENTS INC
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 14 N MAIN ST
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City | MIDDLETON
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State | MA
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Zip | 01949-1712
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Country | US
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Telephone | 978-774-6116
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Fax |
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Provider Business Mailing Address
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Address Line | 92 S MAIN ST
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City | MIDDLETON
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State | MA
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Zip | 01949-2211
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Country | US
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Telephone | 978-774-6100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN L STABILE
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Credential |
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Telephone | 978-774-6116
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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 | 22
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License Number State | MA
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