Organization
MYO-MY MASSAGE AND FITNESS CAFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY MCCANTS (CEO)
(770) 906-5271
Entity
Organization
Contact information
Practice address
12075 HAVANA RD, GARFIELD HEIGHTS, OH 44125-4508
(770) 906-5271
Mailing address
1803 TAMARRON PKWY SE, ATLANTA, GA 30339-6714
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
225700000X
Massage Therapist
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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