Healthcare Provider Details

I. General information

NPI: 1487571279
Provider Name (Legal Business Name): DOROTHEA J MAST LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 HENDERSON RD
COLUMBUS OH
43220-7344
US

IV. Provider business mailing address

1227 WATERFORD DR
COLUMBUS OH
43220-3215
US

V. Phone/Fax

Practice location:
  • Phone: 330-473-9494
  • Fax:
Mailing address:
  • Phone: 330-473-9494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.027433
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: