MEDICARE: SIMPLE HEALING TOUCH MASSAGE

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	:	1962815977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLE HEALING TOUCH MASSAGE

Provider Business Mailing Address
First Line	:	2637 E ATLANTIC BLVD
Second Line	:	SUITE 23774
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-4939
Country	:	US
Telephone Number	:	866-642-4990
Fax Number	:

Provider Business Practice Location Address
First Line	:	2637 E ATLANTIC BLVD
Second Line	:	SUITE 23774
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-4939
Country	:	US
Telephone Number	:	866-642-4990
Fax Number	:

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	MR. CHAD STEVEN BRUCE
Credential	:
Telephone Number	:	866-642-4990

Provider Enumeration Date	:	06/06/2014
Last Update Date	:	06/06/2014

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