=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720845720
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPEUTIC TOUCHES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2024
-----------------------------------------------------
Last Update Date | 03/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8437 CROSSLAND LOOP
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36117-8485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-463-9391
-----------------------------------------------------
Fax | 334-649-1077
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8437 CROSSLAND LOOP
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36117-8485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-463-9391
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NICHOLAS VINES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 334-425-8705
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172M00000X
-----------------------------------------------------
Taxonomy Name | Mechanotherapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------