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General NPI Number Information
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NPI Number | 1992196877
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Entity Type | Organization
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Legal Business Name | TEAM LOVING CARE, LLC
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 02/12/2015
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Provider Practice Location Address
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Address Line | 5897 ROUTE 9
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City | RHINEBECK
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State | NY
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Zip | 12572-3607
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Country | US
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Telephone | 845-516-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 5897 ROUTE 9
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City | RHINEBECK
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State | NY
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Zip | 12572-3607
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Country | US
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Telephone | 845-516-4232
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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 | MS. ANDREA ALLEN BOWEN
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Credential | LMT
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Telephone | 845-516-4232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 023569
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License Number State | NY
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