Provider Demographics
NPI:1508009580
Name:HEALING ARTS MASSAGE CENTER
Entity Type:Organization
Organization Name:HEALING ARTS MASSAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUISTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:813-907-2774
Mailing Address - Street 1:5801 ARGERIAN DR
Mailing Address - Street 2:STE 101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4140
Mailing Address - Country:US
Mailing Address - Phone:813-907-2774
Mailing Address - Fax:813-907-2723
Practice Address - Street 1:5801 ARGERIAN DR
Practice Address - Street 2:STE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4140
Practice Address - Country:US
Practice Address - Phone:813-907-2774
Practice Address - Fax:813-907-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL071065174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTIN