Provider Demographics
NPI:1740064104
Name:LYMPHATIC & MASSAGE STUDIO OF BARBARA WHITE
Entity type:Organization
Organization Name:LYMPHATIC & MASSAGE STUDIO OF BARBARA WHITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, MTI, BCTMB, CLT
Authorized Official - Phone:409-626-1811
Mailing Address - Street 1:3560 DELAWARE ST STE 501
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3061
Mailing Address - Country:US
Mailing Address - Phone:409-626-1811
Mailing Address - Fax:
Practice Address - Street 1:3560 DELAWARE ST STE 501
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3061
Practice Address - Country:US
Practice Address - Phone:409-626-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty