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Organization

EXQUISITE BODY CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CLEMMIE SMALLHORNE (OWNER/MANAGER)
(817) 921-5088
Entity
Organization

Contact information

Practice address
3863 SOUTH FWY, SUITE 118, FORT WORTH, TX 76110-5656
(817) 921-5088
(817) 921-5087
Mailing address
3863 SOUTH FWY, SUITE 118, FORT WORTH, TX 76110-5656
(817) 921-5088
(817) 921-5087

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002346
TX

Other

Enumeration date
04/09/2010
Last updated
04/14/2010
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