1265853444 NPI number — HOLISTIC THERAPEUTIC KNEADS,INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265853444 NPI number — HOLISTIC THERAPEUTIC KNEADS,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLISTIC THERAPEUTIC KNEADS,INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265853444
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2206 PORSHA LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGH POINT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27265-1469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-307-9090
Provider Business Mailing Address Fax Number:
336-841-6984

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2201 EASTCHESTER DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27265-1516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-355-8398
Provider Business Practice Location Address Fax Number:
336-841-6984
Provider Enumeration Date:
12/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
STACHES
Authorized Official First Name:
GRETA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
336-307-9090

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  11850 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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