Cleansing Waters Wellness Center, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

4315 Issued in AL

Legal business name

CLEANSING WATERS WELLNESS CENTER, LLC

Practice address

1300 John R St
Suite B
Muscle Shoals, AL 35661-2255

Phone

(256) 314-2328

Fax

(256) 314-2328

NPI assigned

Sep 21, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nathan A Reynolds, L.M.T.

Title

Owner/Massage Therapist

Phone

(256) 314-2328

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1417326463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 JOHN R ST",
            "address_2": "SUITE B",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612255",
            "telephone_number": "256-314-2328",
            "fax_number": "256-314-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JOHN R ST",
            "address_2": "SUITE B",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612255",
            "telephone_number": "256-314-2328",
            "fax_number": "256-314-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEANSING WATERS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "256-314-2328",
        "authorized_official_credential": "L.M.T."
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "AL",
            "license": "4315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4315",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rommy Cedeno, MD
• Deeksha Chakrabarty
• Robert E Chasan, M.D.
• Anusha Chintapalli, MD
• Amy T Clark, MD
• Tabitha T Clemons, CRNP
• Ashley Taylor Cleveland, LPC
• Bonnie Rachel Cochran, NP
• Colbert Emergency Group LLC
• Amy Michelle Coleman-Kirkman, LICSW

• Massage Therapist in Muscle Shoals, AL
• Providers in Muscle Shoals, AL by specialty
• Massage Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.