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General NPI Number Information
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NPI Number | 1730458985
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL TOUCH MASSAGE THERAPY
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Dates
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Enumeration Date | 12/16/2011
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 19811 HOPPERS CREEK DR
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City | KATY
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State | TX
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Zip | 77449-6631
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Country | US
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Telephone | 832-212-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 1029 HWY 6 N SUITE 650-148
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City | HOUSTON
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State | TX
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Zip | 77079-1043
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Country | US
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Telephone | 832-212-3840
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Fax |
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Authorized Official
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Title or Position | LIC. MEDICAL MASSAGE PRACTITIONER
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Name | TANECIA MCKNIGHT
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Credential | LMMP
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Telephone | 832-212-3840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | MT111423
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License Number State | TX
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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 | MT111423
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | MT111423
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License Number State | TX
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