MEDICARE: RELAX & REJUVENATE 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	:	1922691021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELAX & REJUVENATE LLC

Provider Business Mailing Address
First Line	:	8918 READING RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-3228
Country	:	US
Telephone Number	:	248-755-5301
Fax Number	:

Provider Business Practice Location Address
First Line	:	8918 READING RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-3228
Country	:	US
Telephone Number	:	248-755-5301
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMAL WILSON
Credential	:
Telephone Number	:	248-755-5301

Provider Enumeration Date	:	02/19/2021
Last Update Date	:	02/19/2021

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Directions to “RELAX & REJUVENATE LLC ” Practice Location

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