Organization
MEDICAL MASSAGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA AKACHUKWU LMT (OWNER)
(409) 201-1964
Entity
Organization
Contact information
Practice address
3100 MEMORIAL BLVD, PORT ARTHUR, TX 77640-2734
(409) 201-1964
(409) 982-9090
Mailing address
PO BOX 1376, PORT ARTHUR, TX 77641-1376
(409) 201-1964
(409) 982-9090
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
109921
TX
283X00000X
Rehabilitation Hospital
109921
TX
305R00000X
Preferred Provider Organization
109921
TX
Other
Enumeration date
05/19/2010
Last updated
09/30/2010
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