Provider Demographics
NPI:1114395951
Name:IN TOUCH THERAPEUTIC MASSAGE, LLC
Entity Type:Organization
Organization Name:IN TOUCH THERAPEUTIC MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SURBEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, NMT
Authorized Official - Phone:419-633-0514
Mailing Address - Street 1:1210 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:OH
Mailing Address - Zip Code:43506-3521
Mailing Address - Country:US
Mailing Address - Phone:419-633-0514
Mailing Address - Fax:
Practice Address - Street 1:1210 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-3521
Practice Address - Country:US
Practice Address - Phone:419-633-0514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021085225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty