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General NPI Number Information
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NPI Number | 1972977239
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Entity Type | Organization
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Legal Business Name | NATURAL RHYTHM MASSAGE/FITNESS SUITE,LLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 722 GOVERNOR HOUSE CIR
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City | WILMINGTON
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State | DE
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Zip | 19809-2459
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Country | US
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Telephone | 302-384-6634
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Fax | 302-384-6634
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Provider Business Mailing Address
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Address Line | 722 GOVERNOR HOUSE CIR
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City | WILMINGTON
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State | DE
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Zip | 19809-2459
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Country | US
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Telephone | 302-384-6634
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Fax | 302-384-6634
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. AUGUSTINE OLIVETTE ROGERS
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Credential | L.M.T
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Telephone | 302-384-6634
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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 | MT-0004117
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License Number State | DE
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