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General NPI Number Information
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NPI Number | 1013295666
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Entity Type | Organization
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Legal Business Name | MANTRA MASSAGE AND BODYWORX, LLC
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 4675 COOPER RD
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City | CINCINNATI
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State | OH
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Zip | 45242-6182
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Country | US
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Telephone | 513-891-1324
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Fax | 513-891-1324
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Provider Business Mailing Address
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Address Line | 4675 COOPER RD
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City | CINCINNATI
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State | OH
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Zip | 45242-6182
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Country | US
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Telephone | 513-891-1324
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Fax | 513-891-1324
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Authorized Official
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Title or Position | LMT, OWNER
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Name | MS. MARLA P COHEN
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Credential |
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Telephone | 513-518-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3655
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 65.000207
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 018443
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 018315
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License Number State | OH
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