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General NPI Number Information
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NPI Number | 1275253445
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Entity Type | Organization
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Legal Business Name | LIMITLESS THERAPEUTIC MASSAGE, LLC
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 2260 HEWLETT AVE
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City | MERRICK
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State | NY
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Zip | 11566-3951
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Country | US
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Telephone | 718-810-4717
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Fax | 347-727-0505
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Provider Business Mailing Address
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Address Line | 8413 52ND AVE
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City | ELMHURST
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State | NY
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Zip | 11373-4320
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Country | US
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Telephone | 347-612-2450
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Fax |
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | HAROLD URRUTIA
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Credential | LMT
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Telephone | 786-695-9197
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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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