Provider Demographics
NPI:1871247775
Name:A TOUCH OF GLORY MASSAGE THERAPY LLC
Entity Type:Organization
Organization Name:A TOUCH OF GLORY MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CERTIFIED MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:757-782-1547
Mailing Address - Street 1:5606 GREGORY CT
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-1637
Mailing Address - Country:US
Mailing Address - Phone:757-782-1547
Mailing Address - Fax:410-874-0977
Practice Address - Street 1:355 CRAWFORD ST STE 600C
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2823
Practice Address - Country:US
Practice Address - Phone:757-381-7395
Practice Address - Fax:410-874-0977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty