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General NPI Number Information
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NPI Number | 1982567814
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Entity Type | Organization
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Legal Business Name | RELAX REJUVENATE RESTORE
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 709 S AIR DEPOT BLVD STE D
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City | MIDWEST CITY
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State | OK
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Zip | 73110-4810
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Country | US
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Telephone | 405-882-7592
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Fax |
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Provider Business Mailing Address
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Address Line | 3358 DEL AIRE PL
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City | DEL CITY
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State | OK
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Zip | 73115-4806
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Country | US
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Telephone | 405-882-7592
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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 | KENYA MONIQUE SHINE
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Credential | LMT
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Telephone | 405-882-7204
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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 |
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License Number State |
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