Provider Demographics
NPI:1366203671
Name:BALSAM ROSE MASSAGE
Entity type:Organization
Organization Name:BALSAM ROSE MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GUINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:972-837-5260
Mailing Address - Street 1:1122 BENDING TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1870
Mailing Address - Country:US
Mailing Address - Phone:972-837-5260
Mailing Address - Fax:
Practice Address - Street 1:5850 SAN FELIPE ST STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-8003
Practice Address - Country:US
Practice Address - Phone:832-380-5357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center