Provider Demographics
NPI:1285118133
Name:AN ANGELS TOUCH BODYWORKS, LLC
Entity type:Organization
Organization Name:AN ANGELS TOUCH BODYWORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASTER MASSAGE THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MMT
Authorized Official - Phone:501-259-5727
Mailing Address - Street 1:1645 CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6496
Mailing Address - Country:US
Mailing Address - Phone:501-259-5727
Mailing Address - Fax:
Practice Address - Street 1:607 HARKRIDER ST STE 5
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5692
Practice Address - Country:US
Practice Address - Phone:501-259-5727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty