Organization
BACK IN SHAPE MASSAGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTA JEAN ATWELL L.M.T. (PARTNER/MASSAGE THERAPIST)
(210) 516-5033
Entity
Organization
Contact information
Practice address
1528 E COMMON ST, SUITE 18, NEW BRAUNFELS, TX 78130-3337
(210) 516-5033
(830) 837-5137
Mailing address
1539 DEVIN DR, NEW BRAUNFELS, TX 78130-7764
(210) 516-5033
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT 049022
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
613532800
OWCP/FECA/WORKMAN'S COMP
TX
Enumeration date
03/18/2009
Last updated
09/21/2010
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