Organization
BLACK ROSE ELITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY STARKS (OWNER)
(931) 561-4569
Entity
Organization
Contact information
Practice address
757 E LEWIS AND CLARK PKWY, CLARKSVILLE, IN 47129-2269
(812) 924-7196
Mailing address
600 COUNTRY CLUB DR APT 72, NEW ALBANY, IN 47150-4145
(812) 924-7196
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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