Organization Name: | SUNLIGHT REJUVENATION LLC |
NPI Number: | 1770940165 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SANDY GREEN (OWNER) |
Mailing Address: | 1380 Liberty St Se Salem |
State: | OR US |
Postal Code: | 973024246 |
Phone Number: | 5035879997 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2016 |
NPI Last Update Date: | 01/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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. |