| My Massage Sanctuary, Inc | |
|
101 North Alpine Road Rockford IL 61107 | |
| (779) 423-1700 | |
| (866) 596-1027 |
| Full Name | My Massage Sanctuary, Inc |
|---|---|
| Speciality | Specialist |
| Location | 101 North Alpine Road, Rockford, Illinois |
| Authorized Official Name and Position | Leila I Kayser (CEO) |
| Authorized Official Contact | 8153017809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Massage Sanctuary, Inc 101 North Alpine Road Rockford IL 61107 Ph: (779) 423-1700 | My Massage Sanctuary, Inc 101 North Alpine Road Rockford IL 61107 Ph: (779) 423-1700 |
| NPI Number | 1962643072 |
|---|---|
| Provider Enumeration Date | 03/19/2009 |
| Last Update Date | 03/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962643072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 198.000709 (Illinois) | Secondary |
| 174400000X | Specialist | 227.003938 (Illinois) | Primary |
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Rockford Adult Medicine Associates S C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 534 Roxbury Rd, Rockford, IL 61107 Phone: 815-381-7005 | |
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