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General NPI Number Information
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NPI Number | 1932296902
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Entity Type | Organization
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Legal Business Name | MASSAGEWORKS THERAPY CENTER, LLC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 809 N HAMMONDS FERRY RD
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City | LINTHICUM
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State | MD
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Zip | 21090-1301
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Country | US
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Telephone | 410-789-6550
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Fax | 410-789-6557
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Provider Business Mailing Address
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Address Line | 809 N HAMMONDS FERRY RD
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City | LINTHICUM
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State | MD
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Zip | 21090-1301
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Country | US
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Telephone | 410-789-6550
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Fax | 410-789-6557
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Authorized Official
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Title or Position | MASSAGE THERAPIST / PRINCIPAL
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Name | JENNIFER TOLAND MILLER
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Credential | CMT
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Telephone | 410-789-6550
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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 | M00810
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License Number State | MD
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