NPI 1003295312

Peacock Heavenly Massage

Organisation Massage Therapist Port Arthur, TX

Practice location

Address: 3800 Hwy 365 Regional Square, Port Arthur, TX 77642
Phone: (409) 724-7882
Mailing address: 3800 Hwy 365, Suite 159, Port Arthur, TX 77642

Authorised official

Name: Lucy Mae Peacock
Title: Lis. Massage Therapist
Phone: (409) 724-7882

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MT034536 (TX)

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Registry record

NPI: 1003295312
Entity type: Organization
NPI issued: 20 May 2015
Record last updated: 20 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.