Provider Demographics
NPI:1043643257
Name:INTENSE THERAPY LLC
Entity Type:Organization
Organization Name:INTENSE THERAPY LLC
Other - Org Name:INTENSE THERAPY MEDICAL MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, INTENSE THERAPY LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ITOE
Authorized Official - Last Name:SLININGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CMT
Authorized Official - Phone:916-806-4610
Mailing Address - Street 1:312 NATOMA ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2692
Mailing Address - Country:US
Mailing Address - Phone:916-817-2424
Mailing Address - Fax:916-608-2196
Practice Address - Street 1:100 TEDFORD CT
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8109
Practice Address - Country:US
Practice Address - Phone:916-806-3605
Practice Address - Fax:916-608-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2341261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1861565004OtherNPPES
CA2341OtherCAMTC