Provider Demographics
NPI:1457716623
Name:FOREVERKNEADING
Entity type:Organization
Organization Name:FOREVERKNEADING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASASGE THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:302-540-8885
Mailing Address - Street 1:4 SPRINGFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8351
Mailing Address - Country:US
Mailing Address - Phone:302-540-8885
Mailing Address - Fax:
Practice Address - Street 1:254 CHAPMAN RD
Practice Address - Street 2:TOPKIS BLDG
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5413
Practice Address - Country:US
Practice Address - Phone:888-757-1951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0003675261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty