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NPI Code Detail

MEDICARE: CELESTIAL TOUCH MASSAGE CENTER LLC

MEDICARE: CELESTIAL TOUCH MASSAGE CENTER 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
1225700000XMassage Therapist

General Provider Information

NPI Number : 1295161073
Entity Type Code : Organization
Provider Name (Legal Business Name) : CELESTIAL TOUCH MASSAGE CENTER LLC
Provider Business Mailing Address
First Line : 175 MILTON ST N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-6527
Country : US
Telephone Number : 651-644-2787
Fax Number :
Provider Business Practice Location Address
First Line : 175 MILTON ST N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-6527
Country : US
Telephone Number : 651-644-2787
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : BARRY WOLF
Credential : BS
Telephone Number : 612-867-2734
Provider Enumeration Date : 09/24/2013
Last Update Date : 09/25/2013

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Directions to “CELESTIAL TOUCH MASSAGE CENTER LLC ” Practice Location

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