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General NPI Number Information
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NPI Number | 1639575459
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Entity Type | Organization
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Legal Business Name | POWER OF TOUCH MASSAGE THERPAY
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 15223 CHICAGO RD
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City | DOLTON
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State | IL
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Zip | 60419-2518
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Country | US
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Telephone | 708-205-1554
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Fax |
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Provider Business Mailing Address
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Address Line | 15223 CHICAGO RD
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City | DOLTON
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State | IL
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Zip | 60419-2518
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Country | US
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Telephone | 708-205-1554
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. MARCIA LORENE CUTRIGHT
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Credential | LICENSED MASSAGE THE
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Telephone | 708-205-1554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 227010508
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License Number State | IL
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