Provider Demographics
NPI:1629233911
Name:ANOINTED TOUCH MASSAGE THERAPY
Entity Type:Organization
Organization Name:ANOINTED TOUCH MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED MEDICAL MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED MASSAGE THE
Authorized Official - Phone:270-444-7042
Mailing Address - Street 1:934 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-6810
Mailing Address - Country:US
Mailing Address - Phone:270-444-7042
Mailing Address - Fax:270-444-7042
Practice Address - Street 1:934 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6810
Practice Address - Country:US
Practice Address - Phone:270-444-7042
Practice Address - Fax:270-444-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY1522305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization