Provider Demographics
NPI:1225420219
Name:ANGELIC TOUCH MASSAGE THERAPY & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:ANGELIC TOUCH MASSAGE THERAPY & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:YARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-238-3105
Mailing Address - Street 1:1401 S ARCH AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4202
Mailing Address - Country:US
Mailing Address - Phone:330-238-3105
Mailing Address - Fax:
Practice Address - Street 1:1401 S ARCH AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4202
Practice Address - Country:US
Practice Address - Phone:330-238-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty