Organization
SUNRIDGE MASSAGE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA ANN HALL LMT (OWNER)
(304) 573-9817
Entity
Organization
Contact information
Practice address
102 GUYAN DRIVE, MACARTHUR, WV 25873-0102
(304) 573-9817
Mailing address
PO BOX 389, BOLT, WV 25817-0389
(304) 573-9817
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2001-0739
WV
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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