| NPI | 1780093617 |
|---|---|
| Former Legal Business Name | MIRACLE MASSAGE AND THERAPY CENTER CORP |
| Entity Type | Organization |
| Authorized Contact | ARIEL BORREGO President 502-762-5645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |