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General NPI Number Information
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NPI Number | 1609302280
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Entity Type | Organization
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Legal Business Name | REKINDLE MASSAGE
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 515 N MAIN ST
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City | BORGER
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State | TX
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Zip | 79007-4121
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Country | US
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Telephone | 918-730-8649
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Fax |
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Provider Business Mailing Address
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Address Line | 515 N MAIN ST
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City | BORGER
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State | TX
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Zip | 79007-4121
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Country | US
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Telephone | 918-730-8649
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Fax |
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Authorized Official
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Title or Position | LMT
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Name | MISS SANDRA CATES
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Credential | LMT
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Telephone | 918-730-8649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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