Organization
POPLAR CREEK SPA, LLC
Active
Organization
POPLAR CREEK SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY SIMMONS LMT (OWNER/LICENSED MASSAGE THERAPIST)
(423) 238-5775
Entity
Organization
Contact information
Practice address
5906 MAIN ST STE 140, OOLTEWAH, TN 37363-9297
(423) 238-5775
(423) 961-8113
Mailing address
5906 MAIN ST STE 140, OOLTEWAH, TN 37363-9297
(423) 238-5775
(423) 961-8113
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649687146
—
WA
Enumeration date
05/15/2019
Last updated
05/15/2019
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