MEDICARE: JOANNS HUMBLE HANDS

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	:	1235599366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOANNS HUMBLE HANDS

Provider Business Mailing Address
First Line	:	100 LARK CIR
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23601-2258
Country	:	US
Telephone Number	:	757-591-0125
Fax Number	:

Provider Business Practice Location Address
First Line	:	11719-B JEFFERSON AVE
Second Line	:	STE 106
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-2166
Country	:	US
Telephone Number	:	757-591-0125
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOANN P KNIGHT
Credential	:	BCTMB,CMMP,CPMT
Telephone Number	:	757-591-0125

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	03/02/2016

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Directions to “JOANNS HUMBLE HANDS ” Practice Location

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