Exquisite Body Clinic

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT002346 Issued in TX

Legal business name

EXQUISITE BODY CLINIC

Practice address

3863 South Fwy
Suite 118
Fort Worth, TX 76110-5656

Phone

(817) 921-5088

Fax

(817) 921-5087

NPI assigned

Apr 9, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Clemmie Smallhorne

Title

Owner/Manager

Phone

(817) 921-5088

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1780900118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3863 SOUTH FWY",
            "address_2": "SUITE 118",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761105656",
            "telephone_number": "817-921-5088",
            "fax_number": "817-921-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3863 SOUTH FWY",
            "address_2": "SUITE 118",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761105656",
            "telephone_number": "817-921-5088",
            "fax_number": "817-921-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXQUISITE BODY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "SMALLHORNE",
        "authorized_official_first_name": "CLEMMIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "817-921-5088",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT002346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.