Provider Demographics
NPI:1265853444
Name:HOLISTIC THERAPEUTIC KNEADS,INC
Entity Type:Organization
Organization Name:HOLISTIC THERAPEUTIC KNEADS,INC
Other - Org Name:HOLISTIC THERAPEUTIC KNEADS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:
Authorized Official - Last Name:STACHES
Authorized Official - Suffix:
Authorized Official - Credentials:AM, LMBT, MMP
Authorized Official - Phone:336-307-9090
Mailing Address - Street 1:2206 PORSHA LN
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1469
Mailing Address - Country:US
Mailing Address - Phone:336-307-9090
Mailing Address - Fax:336-841-6984
Practice Address - Street 1:2201 EASTCHESTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1516
Practice Address - Country:US
Practice Address - Phone:336-355-8398
Practice Address - Fax:336-841-6984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-14
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11850225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty