Organization
OUTERBANKS MASSAGE WITH GOULET (OMG)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA LEE GOULET BMBT, MMP (MEDICAL MASSAGE PRACTITIONER)
(252) 305-0285
Entity
Organization
Contact information
Practice address
12 JUNIPER TRL STE 203, SOUTHERN SHORES, NC 27949-3745
(252) 305-0285
Mailing address
12 JUNIPER TRL STE 203, SOUTHERN SHORES, NC 27949-3745
(252) 305-0285
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
14500
NC
261QP2000X
Physical Therapy Clinic/Center
14500
NC
305S00000X
Point of Service
Primary
14500
NC
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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