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General NPI Number Information
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NPI Number | 1922250927
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Entity Type | Organization
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Legal Business Name | ARC THERAPEUTIC MASSAGE, LLC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 401 GALAXIE AVE
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2078
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Country | US
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Telephone | 816-884-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 401 GALAXIE AVE
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2078
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Country | US
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Telephone | 816-884-3039
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DORA DELAINE-WINTER FURLONG
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Credential | LMT, NCTMB
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Telephone | 816-884-3039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2008028618
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License Number State | MO
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