Provider Demographics
NPI:1336991348
Name:THERA-CARE MASSAGE & BODYWORKS LLC
Entity Type:Organization
Organization Name:THERA-CARE MASSAGE & BODYWORKS LLC
Other - Org Name:THERA-CARE MASSAGE & BODYWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MASSAGE THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LETISIA
Authorized Official - Middle Name:REYNA
Authorized Official - Last Name:GAYTAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:361-462-1867
Mailing Address - Street 1:4220 S PADRE ISLAND DR STE A
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4428
Mailing Address - Country:US
Mailing Address - Phone:361-462-1867
Mailing Address - Fax:361-414-9337
Practice Address - Street 1:5959 S STAPLES ST STE 211
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3844
Practice Address - Country:US
Practice Address - Phone:136-146-2186
Practice Address - Fax:361-434-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty