Glow Wellness Spa

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

CE9982276 Issued in FL

Legal business name

GLOW WELLNESS SPA

Practice address

9108 Wiles Rd
Coral Springs, FL 33067-1993

Phone

(954) 755-1744

Fax

(954) 755-8284

NPI assigned

Nov 28, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Thomas J Ryan

Title

Managing Member

Phone

(954) 755-1744

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1972870483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9108 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330671993",
            "telephone_number": "954-755-1744",
            "fax_number": "954-755-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9108 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330671993",
            "telephone_number": "954-755-1744",
            "fax_number": "954-755-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW WELLNESS SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "954-755-1744",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "CE9982276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ryan Goheen
• Benjamin M Goldberg, D.M.D.
• Douglas Goldberg, D.M.D.

• Massage Therapist in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.