Organization Name: | TRANSITIONS BODYWORK CLINIC INC. |
NPI Number: | 1992198261 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TAD DORSEY CHILDERS (CEO) |
Mailing Address: | 2310 S Prairie Ave Pueblo |
State: | CO US |
Postal Code: | 810054801 |
Phone Number: | 7192427263 |
Fax Number: | |
NPI Enumeration Date: | 03/11/2015 |
NPI Last Update Date: | 03/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT.0006794 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
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. |