Healthcare Provider Details

I. General information

NPI: 1427202019
Provider Name (Legal Business Name): TUSCULUM THERAPEUTIC MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2008
Last Update Date: 11/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 COLUMBIA PKWY
CINCINNATI OH
45226-2149
US

IV. Provider business mailing address

3540 COLUMBIA PKWY
CINCINNATI OH
45226-2149
US

V. Phone/Fax

Practice location:
  • Phone: 513-505-3541
  • Fax:
Mailing address:
  • Phone: 513-505-3541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33017166
License Number StateOH

VIII. Authorized Official

Name: MR. WILLIAM ROBERT HULSIZER
Title or Position: OWNER
Credential: LMT
Phone: 513-505-3541