Provider Demographics
NPI:1376878546
Name:RELAX
Entity Type:Organization
Organization Name:RELAX
Other - Org Name:RELAX MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MASSAGE THERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:832-453-5603
Mailing Address - Street 1:2024 WENNECA AVE
Mailing Address - Street 2:
Mailing Address - City:FT. WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102
Mailing Address - Country:US
Mailing Address - Phone:832-453-5603
Mailing Address - Fax:
Practice Address - Street 1:2024 WENNECA AVE
Practice Address - Street 2:
Practice Address - City:FT. WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102
Practice Address - Country:US
Practice Address - Phone:832-453-5603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT101445225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty