Provider Demographics
NPI:1023202488
Name:KNEADING TIME HOLISCTIC THERAPY CENTER
Entity Type:Organization
Organization Name:KNEADING TIME HOLISCTIC THERAPY CENTER
Other - Org Name:KNEADING TIME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEMEO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:419-885-8780
Mailing Address - Street 1:5702 ALEXIS RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2353
Mailing Address - Country:US
Mailing Address - Phone:419-885-8780
Mailing Address - Fax:
Practice Address - Street 1:5702 ALEXIS RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2353
Practice Address - Country:US
Practice Address - Phone:419-885-8780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty