Organization
WAL-INTEREST LLC
Active
Other names
Elements Therapeutic Massage
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF LATHAM (OWNER)
(979) 774-4343
Entity
Organization
Contact information
Practice address
3001 WILDFLOWER DR, SUITE 611, BRYAN, TX 77802-3061
(979) 774-4343
(509) 315-8354
Mailing address
3001 WILDFLOWER DR, SUITE 611, BRYAN, TX 77802-3061
(979) 774-4343
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/30/2009
Last updated
12/30/2009
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