1619284791 NPI number — HEALING MULTIVERSE

Table of content: (NPI 1619284791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619284791 NPI number — HEALING MULTIVERSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING MULTIVERSE
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:
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:
1619284791
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10784
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24543-5014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-345-9648
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
930 MARTIN LUTHER KING JR BLVD
Provider Second Line Business Practice Location Address:
3RD FLOOR MASSAGE ROOM
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514-2656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-345-9648
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SABLINA
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, MASSAGE THERAPIST
Authorized Official Telephone Number:
919-345-9648

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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