Provider Demographics
NPI:1366826307
Name:CANDLEWOOD MASSAGE HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:CANDLEWOOD MASSAGE HEALTH AND WELLNESS
Other - Org Name:CANDLEWOOD HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROJELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-260-0720
Mailing Address - Street 1:15679 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3732
Mailing Address - Country:US
Mailing Address - Phone:210-446-5775
Mailing Address - Fax:210-970-7335
Practice Address - Street 1:15679 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3732
Practice Address - Country:US
Practice Address - Phone:210-446-5775
Practice Address - Fax:210-970-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11259111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty