Organization
DIVINE TOUCH MASAGE
Active
Other names
DTM
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE MATTHIS MASSAGE THERAPIST (OWNER)
(916) 544-7018
Entity
Organization
Contact information
Practice address
4635 ANTELOPE RD APT 112, ANTELOPE, CA 95843-3967
(916) 544-7018
Mailing address
4635 ANTELOPE RD APT 112, ANTELOPE, CA 95843-3967
(916) 544-7018
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
37128
CA
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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