Provider Demographics
NPI:1013587989
Name:KLD THERAPY LLC
Entity Type:Organization
Organization Name:KLD THERAPY LLC
Other - Org Name:MASSAGE THERAPY OF FREDERICKSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBRUHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-699-0458
Mailing Address - Street 1:8901 PEPPERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-2564
Mailing Address - Country:US
Mailing Address - Phone:540-699-0458
Mailing Address - Fax:
Practice Address - Street 1:4805 LASSEN LN
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4270
Practice Address - Country:US
Practice Address - Phone:540-699-0458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KLD THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-01
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty