Healthcare Provider Details

I. General information

NPI: 1427545391
Provider Name (Legal Business Name): MED MASSAGE PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STATE ROUTE 837
WEST ELIZABETH PA
15088
US

IV. Provider business mailing address

238 SHELBY DR
GREENSBURG PA
15601-4974
US

V. Phone/Fax

Practice location:
  • Phone: 412-897-3333
  • Fax:
Mailing address:
  • Phone: 412-897-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG001855
License Number StatePA

VIII. Authorized Official

Name: MS. JODIE STROTRMAN
Title or Position: MASSAGE THERAPIST
Credential: MT
Phone: 412-897-3333