Provider Demographics
NPI:1568185668
Name:WILLOW TREE MASSAGE
Entity Type:Organization
Organization Name:WILLOW TREE MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER & MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:334-443-0460
Mailing Address - Street 1:1548 S US HIGHWAY 231 STE E1
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-4516
Mailing Address - Country:US
Mailing Address - Phone:334-443-0460
Mailing Address - Fax:
Practice Address - Street 1:1548 S US HIGHWAY 231 STE E1
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-4516
Practice Address - Country:US
Practice Address - Phone:334-443-0460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty