Organization Name: | GLOW WELLNESS SPA |
NPI Number: | 1972870483 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS J RYAN (MANAGING MEMBER) |
Mailing Address: | 9108 Wiles Rd Coral Springs |
State: | FL US |
Postal Code: | 330671993 |
Phone Number: | 9547551744 |
Fax Number: | 9547558284 |
NPI Enumeration Date: | 11/28/2011 |
NPI Last Update Date: | 11/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | CE9982276 |
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. |