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General NPI Number Information
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NPI Number | 1194698654
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Entity Type | Organization
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Legal Business Name | MOUNTAINSIDE MASSAGE
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 15455 W BELL RD
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City | SURPRISE
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State | AZ
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Zip | 85374-3411
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Country | US
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Telephone | 602-567-8024
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Fax |
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Provider Business Mailing Address
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Address Line | 9727 N 182ND LN
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City | WADDELL
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State | AZ
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Zip | 85355-4273
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Country | US
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Telephone | 602-567-8024
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH CROWELL
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Credential | LICENSED L.M.T.
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Telephone | 480-708-6218
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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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