Provider Demographics
NPI:1053844977
Name:TREAT MASSAGE THERAPY LLC
Entity Type:Organization
Organization Name:TREAT MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:TREAT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:612-250-8620
Mailing Address - Street 1:812 E 48TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1067
Mailing Address - Country:US
Mailing Address - Phone:612-250-8620
Mailing Address - Fax:
Practice Address - Street 1:812 E 48TH ST STE 2
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-1067
Practice Address - Country:US
Practice Address - Phone:612-250-8620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL322 50261225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty