Organization Name: | DEEP KNEAD MEDSPA |
NPI Number: | 1023358199 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARCY REGINA MORGAN (OWNER/EXECUTIVE DIRECTOR) |
Mailing Address: | 117 Nw Monroe Ave Mayo |
State: | FL US |
Postal Code: | 32066 |
Phone Number: | 3525149887 |
Fax Number: | 3523723159 |
NPI Enumeration Date: | 02/26/2013 |
NPI Last Update Date: | 05/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA24270 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |