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General NPI Number Information
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NPI Number | 1194405100
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Entity Type | Organization
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Legal Business Name | TSL MASSAGE THERAPY PC
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 100 MARINERS WAY
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1848
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Country | US
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Telephone | 631-991-0052
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CLUB HOUSE LN
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City | MANORVILLE
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State | NY
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Zip | 11949-2825
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Country | US
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Telephone | 631-991-0052
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Fax |
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Authorized Official
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Title or Position | CEO & FOUNDER
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Name | TARA LAWLESS
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Credential |
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Telephone | 631-991-0052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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