Provider Demographics
NPI:1740677046
Name:MASSAGE & BODYWORKZ OF ARLINGTON
Entity type:Organization
Organization Name:MASSAGE & BODYWORKZ OF ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMT
Authorized Official - Phone:817-703-9942
Mailing Address - Street 1:501 PECAN ACRES CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-7100
Mailing Address - Country:US
Mailing Address - Phone:817-703-9942
Mailing Address - Fax:
Practice Address - Street 1:3010 W PARK ROW DR
Practice Address - Street 2:NONE
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-2048
Practice Address - Country:US
Practice Address - Phone:817-703-9942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT118103225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty