Provider Demographics
NPI:1306184114
Name:CERTIFIED HANDS MASSAGE THERAPY
Entity Type:Organization
Organization Name:CERTIFIED HANDS MASSAGE THERAPY
Other - Org Name:CERTIFIED HANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:909-437-4448
Mailing Address - Street 1:7890 HAVEN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3051
Mailing Address - Country:US
Mailing Address - Phone:800-680-5636
Mailing Address - Fax:
Practice Address - Street 1:7890 HAVEN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3051
Practice Address - Country:US
Practice Address - Phone:800-680-5636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26944174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty