Provider Demographics
NPI:1972914885
Name:KNEADING PALMS MASSAGE
Entity Type:Organization
Organization Name:KNEADING PALMS MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:405-334-3232
Mailing Address - Street 1:4806 N PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1710
Mailing Address - Country:US
Mailing Address - Phone:405-334-7812
Mailing Address - Fax:
Practice Address - Street 1:4806 N PERKINS RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-1710
Practice Address - Country:US
Practice Address - Phone:405-334-7812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0001474261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation