MEDICARE: RICHMOND SPORTS MASSAGE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1801742713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND SPORTS MASSAGE, LLC

Provider Business Mailing Address
First Line	:	2226 W MAIN ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2226 W MAIN ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4433
Country	:	US
Telephone Number	:	804-647-0266
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LELA FERRANTI WHITE
Credential	:	LMT
Telephone Number	:	804-647-0266

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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