Organization
12 HOUR MASSAGE 2 LLC
Active
Organization
12 HOUR MASSAGE 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOLLI COCO GRAVES LMT (CO-OWNER & LMT)
(337) 302-1675
Entity
Organization
Contact information
Practice address
3113 RYAN ST STE 6, LAKE CHARLES, LA 70601-8587
(337) 802-9631
Mailing address
3113 RYAN ST STE 6, LAKE CHARLES, LA 70601-8587
(337) 802-9631
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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