Provider Demographics
NPI:1609329044
Name:HEALING PALM
Entity Type:Organization
Organization Name:HEALING PALM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SAINT LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:502-422-0075
Mailing Address - Street 1:3415 BARDSTOWN RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4605
Mailing Address - Country:US
Mailing Address - Phone:502-422-0075
Mailing Address - Fax:
Practice Address - Street 1:3415 BARDSTOWN RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4605
Practice Address - Country:US
Practice Address - Phone:502-422-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1156171W00000X
KYKY1156171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1OtherAUTO INSURANCE
KYKY-1156OtherAUTO INSURANCE