Organization
SOL MEDICAL MASSAGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LETICIA REYES LICENSED MASSAGE (MASSAGE PRACTICIONER)
(469) 701-1097
Entity
Organization
Contact information
Practice address
4666 MCDERMOTT RD SUITE 100, PLANO, TX 75024
(972) 668-6868
Mailing address
PO BOX 118381, CARROLLTON, TX 75011-8381
(469) 701-1097
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT102405
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102405
MASSAGE LICENSE
TX
Enumeration date
02/07/2018
Last updated
06/16/2018
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