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General NPI Number Information
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NPI Number | 1891019725
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Entity Type | Organization
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Legal Business Name | GLEN HEALING MASSAGE INC.
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Dates
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Enumeration Date | 03/22/2010
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 9600 SW 8TH ST SUITE 26
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City | MIAMI
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State | FL
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Zip | 33174-2900
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Country | US
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Telephone | 305-846-9760
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Fax | 305-846-9761
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Provider Business Mailing Address
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Address Line | 9600 SW 8TH ST SUITE 26
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City | MIAMI
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State | FL
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Zip | 33174-2900
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Country | US
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Telephone | 305-846-9760
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Fax | 305-846-9761
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS DUNAY AGUIAR
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Credential | LMT
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Telephone | 305-846-9760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MA53225
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License Number State | FL
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