Provider Demographics
NPI:1750038840
Name:HANDS OF GRACE MASSAGE THERAPY
Entity Type:Organization
Organization Name:HANDS OF GRACE MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:361-741-0838
Mailing Address - Street 1:2001 S STAPLES ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3000
Mailing Address - Country:US
Mailing Address - Phone:361-334-1073
Mailing Address - Fax:361-334-1025
Practice Address - Street 1:2001 S STAPLES ST STE 100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3000
Practice Address - Country:US
Practice Address - Phone:361-334-1073
Practice Address - Fax:361-334-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty