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NPI 1417362401

OrganizationActive

A Healthy Massage By Modesta

NPI 1417362401 · Point of Service · El Paso, TX

Provider details

NPI number: 1417362401
Entity type: Organization
Primary specialty: Point of ServiceManaged Care Organizations
Authorized official: Modesta Van Den Bogaard, Licensed Massage Therapist
License: 101448 (TX)

Practice location

9047 Polaris St

El Paso, TX 79904-1122

Phone: (915) 588-2167

More TX providers

Mailing address

9047 Polaris St

El Paso, TX 79904-1122

Registry dates

Enumerated: 2014-06-27
Last updated: 2014-06-27

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

A Healthy Massage By Modesta — NPI 1417362401, El Paso, TX | NPI Central