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General NPI Number Information
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NPI Number | 1740552181
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Entity Type | Organization
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Legal Business Name | A TIME OF REFRESHING SALON AND DAY SPA, LLC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 116 W MAIN ST
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City | WALLACE
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State | NC
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Zip | 28466-2902
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Country | US
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Telephone | 910-285-0929
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Fax | 910-285-9029
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Provider Business Mailing Address
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Address Line | PO BOX 1557
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City | WALLACE
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State | NC
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Zip | 28466-3557
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Country | US
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Telephone | 910-285-0929
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Fax | 910-285-9029
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAN A SMITH
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Credential |
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Telephone | 910-540-2076
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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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