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General NPI Number Information
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NPI Number | 1629832464
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Entity Type | Organization
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Legal Business Name | TOUCHED BY A ROSE
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 15 ATLANTIC AVE STE 305
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City | LYNBROOK
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State | NY
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Zip | 11563-3051
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Country | US
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Telephone | 516-545-0056
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Fax | 518-585-4404
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Provider Business Mailing Address
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Address Line | 12 RUSSELL ST
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City | LYNBROOK
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State | NY
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Zip | 11563-1145
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Country | US
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Telephone | 516-545-0056
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Fax | 518-585-4404
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Authorized Official
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Title or Position | PRESIDENT
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Name | AUDREY DONALDSON
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Credential | LMT
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Telephone | 516-545-0056
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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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