Provider Demographics
NPI:1033449004
Name:MASSAGE THERAPIES, INC.
Entity Type:Organization
Organization Name:MASSAGE THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LORAIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:801-510-5627
Mailing Address - Street 1:3725 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-1754
Mailing Address - Country:US
Mailing Address - Phone:801-510-5627
Mailing Address - Fax:
Practice Address - Street 1:3725 WASHINGTON BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-1754
Practice Address - Country:US
Practice Address - Phone:801-510-5627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5532319-0142225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty