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General NPI Number Information
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NPI Number | 1780295428
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Entity Type | Organization
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Legal Business Name | MASSAGE IN SESSION, INC.
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Dates
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Enumeration Date | 08/16/2020
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Last Update Date | 08/16/2020
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Provider Practice Location Address
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Address Line | 869 STOCKTON ST STE 8
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3590
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Country | US
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Telephone | 904-403-9940
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Fax |
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Provider Business Mailing Address
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Address Line | 8339 WEYBRIDGE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32244-6198
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Country | US
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Telephone | 904-403-9940
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CRYSTAL DELGADO MCCRAW
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Credential | LMT
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Telephone | 904-403-9940
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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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