Provider Demographics
NPI:1376787309
Name:THE CARING TOUCH BY GARY & SANDY
Entity Type:Organization
Organization Name:THE CARING TOUCH BY GARY & SANDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:262-502-4051
Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:20079 W. MAIN ST. SUITE B
Mailing Address - City:LANNON
Mailing Address - State:WI
Mailing Address - Zip Code:53046
Mailing Address - Country:US
Mailing Address - Phone:262-502-4051
Mailing Address - Fax:262-502-4053
Practice Address - Street 1:20079 W. MAIN ST.
Practice Address - Street 2:SUITE B
Practice Address - City:LANNON
Practice Address - State:WI
Practice Address - Zip Code:53046
Practice Address - Country:US
Practice Address - Phone:262-502-4051
Practice Address - Fax:262-502-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI743-046225700000X
WI731-046225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty