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General NPI Number Information
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NPI Number | 1881091775
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Entity Type | Organization
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Legal Business Name | GIVING BACK & BODY WORK
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 10200 TATE CT
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City | CONROE
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State | TX
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Zip | 77385-3791
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Country | US
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Telephone | 832-231-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 10200 TATE CT
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City | CONROE
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State | TX
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Zip | 77385-3791
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Country | US
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Telephone | 832-231-9353
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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 | MS. KATHYJO WELTY
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Credential | MT
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Telephone | 832-231-9353
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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 | MT119038
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License Number State | TX
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