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General NPI Number Information
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NPI Number | 1962766535
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Entity Type | Organization
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Legal Business Name | MEDICAL MASSAGE PROFESSIONALS LLC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 8705 COLESVILLE RD SUITE B-198
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City | SILVER SPRING
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State | MD
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Zip | 20910-3903
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Country | US
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Telephone | 240-506-7470
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Fax |
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Provider Business Mailing Address
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Address Line | 8705 COLESVILLE RD SUITE B-198
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City | SILVER SPRING
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State | MD
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Zip | 20910-3903
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Country | US
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Telephone | 240-506-7470
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MS. THERESA ESCOFFERY
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Credential | BCTMB, MMT, LMT, CMT
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Telephone | 240-506-7470
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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 | R01540
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License Number State | MD
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