Organization
NALANI'S LMT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE MARIE JACKSON VICENTE LMT (OWNER)
(937) 623-0689
Entity
Organization
Contact information
Practice address
5773 FAR HILLS AVE, CENTERVILLE, OH 45429-2207
(937) 727-3111
Mailing address
5349 DUSHORE DR, DAYTON, OH 45417-8831
(937) 727-3111
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
—
—
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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