Provider Demographics
NPI:1801201827
Name:SINCERE TOUCH MASSAGE
Entity Type:Organization
Organization Name:SINCERE TOUCH MASSAGE
Other - Org Name:SINCERE TOUCH MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:NMT
Authorized Official - Phone:240-222-2377
Mailing Address - Street 1:3560 MALVERN ST APT 123
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-7210
Mailing Address - Country:US
Mailing Address - Phone:240-222-2377
Mailing Address - Fax:
Practice Address - Street 1:130 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3417
Practice Address - Country:US
Practice Address - Phone:240-222-2377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SINCERE TOUCH MASSAGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019012152174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty