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Organization
STRESSAGE THERAPY
Active
Organization
STRESSAGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY ALEXANDER HICKS CMT (SPORTS REHABILITATION THERAPIST)
(619) 519-3632
Entity
Organization
Contact information
Practice address
8300 UNIVERSITY AVE, LA MESA, CA 91942-9323
(619) 622-1963
Mailing address
8300 UNIVERSITY AVE, LA MESA, CA 91942-9323
(619) 622-1963
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
261QR0800X
Recovery Care Clinic/Center
—
NULL
Other
Enumeration date
07/19/2017
Last updated
11/12/2019
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