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General NPI Number Information
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NPI Number | 1326955675
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Entity Type | Organization
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Legal Business Name | MEDINAS THERAPEUTIC MASSAGE LLC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 2832 W WILSHIRE BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-4028
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Country | US
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Telephone | 405-802-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 4320 PALISADE LN
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City | OKLAHOMA CITY
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State | OK
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Zip | 73179-1640
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Country | US
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Telephone | 405-802-5291
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MR. ANTHONY MEDINA
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Credential | LMT
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Telephone | 405-802-5292
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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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