Provider Demographics
NPI:1124218953
Name:POWER OF TOUCH MASSAGE INC.
Entity Type:Organization
Organization Name:POWER OF TOUCH MASSAGE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:LESCAK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:912-685-2418
Mailing Address - Street 1:18 SE BROAD ST
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-4428
Mailing Address - Country:US
Mailing Address - Phone:912-685-2418
Mailing Address - Fax:
Practice Address - Street 1:18 SE BROAD ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439-4428
Practice Address - Country:US
Practice Address - Phone:912-685-2418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT 000002174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty