| NPI | 1104253285 |
|---|---|
| Former Legal Business Name | MASSAGE REVOLUTION, LLC |
| Entity Type | Organization |
| Authorized Contact | ABRAHAM SANTA CRUZ Operations Manager 601-918-1853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MS 2027) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |