MEDICARE: AT PEACE MASSAGE THERAPY CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1144106147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT PEACE MASSAGE THERAPY CLINIC LLC

Provider Business Mailing Address
First Line	:	242 W VALLEY AVE # 212
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-3634
Country	:	US
Telephone Number	:	205-899-2975
Fax Number	:

Provider Business Practice Location Address
First Line	:	242 W VALLEY AVE # 212
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-3634
Country	:	US
Telephone Number	:	205-899-2975
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LEKIA SHUNAE WELDON
Credential	:	LMT 3418, MLD-C
Telephone Number	:	205-899-2975

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	08/14/2025

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