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General NPI Number Information
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NPI Number | 1528201050
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Entity Type | Organization
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Legal Business Name | INERTIA MASSAGE THERAPY,LLC
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 4510 COLLINS BLVD SUITE 4
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City | ASHTABULA
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State | OH
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Zip | 44004-6954
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Country | US
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Telephone | 440-997-0014
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Fax | 440-998-7032
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Provider Business Mailing Address
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Address Line | 4510 COLLINS BLVD SUITE 4
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City | ASHTABULA
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State | OH
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Zip | 44004-6954
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Country | US
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Telephone | 440-997-0014
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Fax | 440-998-7032
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER L BURNS
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Credential | L.M.T.
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Telephone | 440-840-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 33.016868
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License Number State | OH
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