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General NPI Number Information
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NPI Number | 1629473681
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Entity Type | Organization
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Legal Business Name | JUST RELAX LLC
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Dates
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Enumeration Date | 11/01/2014
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Last Update Date | 11/01/2014
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Provider Practice Location Address
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Address Line | 9363 SCARLET OAK DR
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City | MANASSAS
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State | VA
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Zip | 20110-5669
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Country | US
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Telephone | 703-850-2310
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Fax |
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Provider Business Mailing Address
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Address Line | 9363 SCARLET OAK DR
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City | MANASSAS
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State | VA
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Zip | 20110-5669
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Country | US
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Telephone | 703-850-2310
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JEANNIE WALKER
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Credential |
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Telephone | 703-850-2310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019001640
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License Number State | VA
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