=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841598125
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAGGI (MARGARET) LOUISE PERL L.M.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2011
-----------------------------------------------------
Last Update Date | 10/03/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | AT SHARON'S KUT & KURL WHITE'S SHOPPING PLAZA MAGGI'S MASSAGE THERAPY
-----------------------------------------------------
City | HAMLIN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-561-7896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 78 MAGGI LANE
-----------------------------------------------------
City | SIAS
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-778-3772
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 1998-0202
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------