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General NPI Number Information
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NPI Number | 1871133678
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Entity Type | Organization
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Legal Business Name | GLOWING HEART BODYWORK
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 455 3RD ST FL 2
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City | BEAVER
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State | PA
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Zip | 15009-2266
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Country | US
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Telephone | 724-774-8729
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 5TH AVE
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City | BEAVER FALLS
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State | PA
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Zip | 15010-3614
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Country | US
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Telephone | 724-888-3138
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Fax |
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Authorized Official
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Title or Position | OWNER, MASSAGE THERAPIS
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Name | TERRANCE EDWARD SWEET
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Credential | RN, LMT
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Telephone | 724-888-3138
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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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