Provider Demographics
NPI:1780204255
Name:DIVINE TOUCH TX PLLC
Entity Type:Organization
Organization Name:DIVINE TOUCH TX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/LMT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:JANAY
Authorized Official - Last Name:WHIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:254-702-6864
Mailing Address - Street 1:6312 ALABASTER DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5729
Mailing Address - Country:US
Mailing Address - Phone:254-702-6864
Mailing Address - Fax:
Practice Address - Street 1:4008 E STAN SCHLUETER LOOP STE 108
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-8537
Practice Address - Country:US
Practice Address - Phone:254-245-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty