Provider Demographics
NPI:1609302280
Name:REKINDLE MASSAGE
Entity Type:Organization
Organization Name:REKINDLE MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:918-730-8649
Mailing Address - Street 1:515 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-4121
Mailing Address - Country:US
Mailing Address - Phone:918-730-8649
Mailing Address - Fax:
Practice Address - Street 1:515 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4121
Practice Address - Country:US
Practice Address - Phone:918-730-8649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty