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General NPI Number Information
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NPI Number | 1215888953
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Entity Type | Organization
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Legal Business Name | THE RECOVERY ROOM MEDICAL AND SPORTS MASSAGE
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 18409 HIGHWAY 105 W STE D
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City | MONTGOMERY
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State | TX
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Zip | 77356-6105
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Country | US
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Telephone | 936-693-4488
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Fax |
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Provider Business Mailing Address
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Address Line | 26477 OLD HIGHWAY 105 W
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City | MONTGOMERY
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State | TX
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Zip | 77316-1969
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Country | US
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Telephone | 936-693-4488
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | SHAWNA LYNN MAHON
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Credential | LMT,MMT
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Telephone | 936-693-4488
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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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