Provider Demographics
NPI:1912439514
Name:MAGIC TOUCH TM LLC
Entity Type:Organization
Organization Name:MAGIC TOUCH TM LLC
Other - Org Name:MAGIC TOUCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:985-796-7246
Mailing Address - Street 1:2763A SGT ALFRED DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-4013
Mailing Address - Country:US
Mailing Address - Phone:985-796-7246
Mailing Address - Fax:
Practice Address - Street 1:2763A SGT ALFRED DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-4013
Practice Address - Country:US
Practice Address - Phone:985-796-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8472405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty