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Active
Other names
The Massage Evolution & Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
TARA D COOK LCNT, LMBT (OWNER)
(803) 746-7044
Entity
Organization

Contact information

Practice address
2025 EBENEZER RD, SUITE E, ROCK HILL, SC 29732-1062
(803) 746-7044
Mailing address
2025 EBENEZER RD, SUITE E, ROCK HILL, SC 29732-1062
(803) 746-7044

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
225700000X
Massage Therapist
Primary
225XP0019X
Physical Rehabilitation Occupational Therapist
226300000X
Kinesiotherapist

Other

Enumeration date
01/22/2015
Last updated
01/22/2015
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