Provider Demographics
NPI:1447536198
Name:LAY YOUR HANDS ON ME
Entity type:Organization
Organization Name:LAY YOUR HANDS ON ME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL MASSAGE PRACTIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:ALTON
Authorized Official - Last Name:PAYTON
Authorized Official - Suffix:I
Authorized Official - Credentials:LMT,MMP
Authorized Official - Phone:214-718-4177
Mailing Address - Street 1:1414 SHILOH RD
Mailing Address - Street 2:APT 4021
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8257
Mailing Address - Country:US
Mailing Address - Phone:214-718-4177
Mailing Address - Fax:972-941-6547
Practice Address - Street 1:414 E WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4829
Practice Address - Country:US
Practice Address - Phone:214-718-4177
Practice Address - Fax:972-941-6541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT039221302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization