Provider Demographics
NPI:1417420605
Name:COMPLETE HEALTH MASSAGE
Entity Type:Organization
Organization Name:COMPLETE HEALTH MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEANNA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:CASTEEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT,MMP
Authorized Official - Phone:254-247-7075
Mailing Address - Street 1:2109 PIRTLE DR
Mailing Address - Street 2:
Mailing Address - City:SALADO
Mailing Address - State:TX
Mailing Address - Zip Code:76571-6195
Mailing Address - Country:US
Mailing Address - Phone:254-247-7075
Mailing Address - Fax:
Practice Address - Street 1:2201 S W S YOUNG DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5317
Practice Address - Country:US
Practice Address - Phone:254-247-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty