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General NPI Number Information
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NPI Number | 1407679905
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Entity Type | Organization
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Legal Business Name | MASSAGE RX LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 387 COUNTY LINE RD W STE 225
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City | WESTERVILLE
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State | OH
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Zip | 43082-6918
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Country | US
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Telephone | 614-218-5512
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Fax | 614-882-4475
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Provider Business Mailing Address
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Address Line | 393 HICKORY LN
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City | WESTERVILLE
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State | OH
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Zip | 43081-3082
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Country | US
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Telephone | 614-218-5512
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. TONYA NICOLE CROAK
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Credential | LMT
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Telephone | 614-218-5512
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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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