Organization
MYSTIC PARADISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA CHRISTINE SHILTZ (MEMBER/MASSAGE THERAPIST)
(304) 638-2113
Entity
Organization
Contact information
Practice address
1765 US ROUTE 60, HURRICANE, WV 25526-2552
(304) 638-2113
Mailing address
RR 3 BOX 308A, MILTON, WV 25541-9518
(304) 638-2113
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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