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General NPI Number Information
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NPI Number | 1750516084
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Entity Type | Organization
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Legal Business Name | WAI PAIN MANAGEMENT MASSAGE THERAPY
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 934 ARCH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-3107
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Country | US
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Telephone | 267-255-4039
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Fax | 215-829-0499
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Provider Business Mailing Address
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Address Line | 1231 CHESTNUT ST # 128
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4105
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Country | US
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Telephone | 267-255-4039
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Fax | 215-829-0499
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Authorized Official
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Title or Position | MASSAGE THERAPIT
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Name | MS. WAI MUN AU
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Credential |
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Telephone | 267-255-4039
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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 | 207881
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License Number State | PA
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