Provider Demographics
NPI:1417682246
Name:REGAL HEALING LLC
Entity Type:Organization
Organization Name:REGAL HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:301-338-8129
Mailing Address - Street 1:5509 WILLOW GROVE CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5611
Mailing Address - Country:US
Mailing Address - Phone:301-919-9107
Mailing Address - Fax:
Practice Address - Street 1:5509 WILLOW GROVE CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5611
Practice Address - Country:US
Practice Address - Phone:301-919-9107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty