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General NPI Number Information
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NPI Number | 1861329195
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Entity Type | Organization
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Legal Business Name | COLLEEN EIDEMILLER LMT,LLC
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 1360 W MAIN ST FRNT DOOR
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City | TIPP CITY
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State | OH
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Zip | 45371-3326
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Country | US
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Telephone | 937-266-9756
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Fax | 937-848-1926
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Provider Business Mailing Address
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Address Line | 3281 W STATE ROUTE 571
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City | TROY
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State | OH
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Zip | 45373-7521
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Country | US
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Telephone | 937-266-9756
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Fax | 937-848-1926
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Authorized Official
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Title or Position | OWNER
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Name | COLLEEN EIDEMILLER
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Credential | LMT
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Telephone | 937-266-9756
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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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