=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760303655
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TENSION RELIEF MASSAGE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2026
-----------------------------------------------------
Last Update Date | 07/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 846 CHURCH ST
-----------------------------------------------------
City | HAWLEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18428-1438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-225-1624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 103 WYOMING AVE
-----------------------------------------------------
City | HAWLEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18428-1035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-469-4503
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. ELISE ROSE FITZGERALD
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 570-225-1624
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------