Provider Demographics
NPI:1649566985
Name:HEALTHY TOUCH THERAPEUTIC MASSAGE
Entity Type:Organization
Organization Name:HEALTHY TOUCH THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:NCMT
Authorized Official - Phone:757-595-0029
Mailing Address - Street 1:708 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4547
Mailing Address - Country:US
Mailing Address - Phone:757-595-0029
Mailing Address - Fax:757-595-8911
Practice Address - Street 1:708 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4547
Practice Address - Country:US
Practice Address - Phone:757-595-0029
Practice Address - Fax:757-595-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA19003874225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty