Provider Demographics
NPI:1972079606
Name:MORGANICS MASSAGE LLC
Entity Type:Organization
Organization Name:MORGANICS MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MORGANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HART-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:843-246-0668
Mailing Address - Street 1:3069 SWEETPINE LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29527-5908
Mailing Address - Country:US
Mailing Address - Phone:843-246-0668
Mailing Address - Fax:
Practice Address - Street 1:1293 PROFESSIONAL DR STE A
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5754
Practice Address - Country:US
Practice Address - Phone:843-240-6092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-20
Last Update Date:2018-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty