Organization
OUTERBANKS MASSAGE WITH GOULET (OMG)
Active
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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