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General NPI Number Information
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NPI Number | 1336779800
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Entity Type | Organization
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Legal Business Name | KNEAD MORE MASSAGE
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 466 COUNTY ROAD 11
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-9260
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Country | US
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Telephone | 937-404-1214
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Fax |
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Provider Business Mailing Address
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Address Line | 466 COUNTY ROAD 11
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-9260
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Country | US
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Telephone | 937-404-1214
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE AUGUSTUS
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Credential | LMT, BCTMB, CMA
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Telephone | 937-404-1214
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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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