# MALISSAMASSAGESLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497508360
- **Authorized official:** MALISSA MARIE EDWARDS (OWNER)
- **Authorized official phone:** (925) 529-5840

## Contact information

- **Practice address:** 305 COVENTRY CIR, BRENTWOOD, CA 94513-2792
- **Practice address phone:** (925) 529-5840
- **Mailing address:** 305 COVENTRY CIR, BRENTWOOD, CA 94513-2792
- **Mailing address phone:** (925) 529-5840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM1400X | Nurse Massage Therapist (NMT) | — | NULL | Yes |
| 163WM1400X | Nurse Massage Therapist (NMT) | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2024
- **Last updated:** 04/09/2024