Provider Demographics
NPI:1255081915
Name:E'S MASSAGE AND RELAXATION: THE TOTAL MAN: MIND, BODY, AND SOUL
Entity type:Organization
Organization Name:E'S MASSAGE AND RELAXATION: THE TOTAL MAN: MIND, BODY, AND SOUL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:334-473-1635
Mailing Address - Street 1:728 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:36089-2151
Mailing Address - Country:US
Mailing Address - Phone:334-748-8670
Mailing Address - Fax:
Practice Address - Street 1:214 PRAIRIE ST N
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:36089-1651
Practice Address - Country:US
Practice Address - Phone:334-473-1635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty