Organization Name: | TIMELESS INNERGY |
NPI Number: | 1447548516 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FOXYRAE CAMPBELL (OWNER/NEUROMUSCULAR THERAPIST) |
Mailing Address: | 4614 Wilgrove Mint Hill Rd Suite C-11 Mint Hill |
State: | NC US |
Postal Code: | 282273500 |
Phone Number: | 7046817671 |
Fax Number: | 7046817671 |
NPI Enumeration Date: | 07/11/2011 |
NPI Last Update Date: | 07/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 11113 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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. |