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General NPI Number Information
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NPI Number | 1801201827
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Entity Type | Organization
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Legal Business Name | SINCERE TOUCH MASSAGE
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 130 W JEFFERSON ST
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3417
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Country | US
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Telephone | 240-222-2377
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Fax |
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Provider Business Mailing Address
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Address Line | 3560 MALVERN ST APT 123
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City | WALDORF
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State | MD
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Zip | 20603-7210
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Country | US
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Telephone | 240-222-2377
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MR. CARL ERIC NELSON
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Credential | NMT
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Telephone | 240-222-2377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0019012152
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License Number State | VA
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