Organization
WAL-INTEREST LLC
Active
Parent organization
SAME
Other names
Elements Therapeutic Massage
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAME
Authorized official
CLIFF LATHAM (OWNER)
(979) 696-2000
Entity
Organization
Contact information
Practice address
3975 STATE HIGHWAY 6 S, COLLEGE STATION, TX 77845-5895
(979) 696-2000
Mailing address
3975 STATE HIGHWAY 6 S, COLLEGE STATION, TX 77845-5895
(979) 696-2000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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