Individual
RITA MAE BALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
2892 FM 367 E, IOWA PARK, TX 76367-7312
(940) 733-9398
Mailing address
2892 FM 367 E, IOWA PARK, TX 76367-7312
(940) 733-9398
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT041278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT041278
STATE LICENSE NUMBER
TX
Enumeration date
06/13/2011
Last updated
03/22/2012
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