Provider Demographics
NPI:1467998690
Name:INSTITUTE OF HARMONIC MASSAGE
Entity Type:Organization
Organization Name:INSTITUTE OF HARMONIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:POWERS
Authorized Official - Last Name:BALFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-529-0229
Mailing Address - Street 1:901 W FM 544
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4915
Mailing Address - Country:US
Mailing Address - Phone:972-429-6335
Mailing Address - Fax:972-429-6337
Practice Address - Street 1:901 W FM 544
Practice Address - Street 2:SUITE 600
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4915
Practice Address - Country:US
Practice Address - Phone:972-429-6335
Practice Address - Fax:972-429-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X
MT024244225700000X
TXME3587302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty