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General NPI Number Information
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NPI Number | 1932523297
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Entity Type | Organization
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Legal Business Name | PLEASURES II WELLNESS,LLC
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 3002 ARKENDALE ST
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1238
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Country | US
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Telephone | 703-763-3106
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Fax | 703-763-3107
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Provider Business Mailing Address
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Address Line | 3002 ARKENDALE ST
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1238
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Country | US
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Telephone | 703-763-3106
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Fax | 703-763-3107
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Authorized Official
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Title or Position | MASSAGE THERAPIST/FITNESS INSTRUCTO
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Name | MRS. MICHELLE DENISE TALBOT
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Credential | LMT,CYFI
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Telephone | 703-763-3106
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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 | 0019006655
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License Number State | VA
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