Organization
MASSAGE BY JANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANA K TIDWELL LMT (OWNER)
(318) 729-0278
Entity
Organization
Contact information
Practice address
3834 INDEPENDENCE DR, ALEXANDRIA, LA 71303-3533
(318) 487-0960
(318) 487-2002
Mailing address
3834 INDEPENDENCE DR, ALEXANDRIA, LA 71303-3533
(318) 487-0960
(318) 487-2002
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2759
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831606664
NPI-INDIVIDUAL PROVIDER
—
01
—
2759
LMT NUMBER
LA
Enumeration date
02/12/2018
Last updated
02/12/2018
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