Provider Demographics
NPI:1558823062
Name:KNEAD TO HEAL LLC
Entity Type:Organization
Organization Name:KNEAD TO HEAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LLOYREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:MMP
Authorized Official - Phone:757-660-1796
Mailing Address - Street 1:813 DILIGENCE DR STE 121C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4285
Mailing Address - Country:US
Mailing Address - Phone:757-744-4325
Mailing Address - Fax:
Practice Address - Street 1:813 DILIGENCE DR STE 121C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4285
Practice Address - Country:US
Practice Address - Phone:757-660-1796
Practice Address - Fax:757-782-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty