Provider Demographics
NPI:1124356068
Name:SALT PIER, LLC
Entity Type:Organization
Organization Name:SALT PIER, LLC
Other - Org Name:ELEMENTS THERAPEUTIC MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENESKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-514-2211
Mailing Address - Street 1:2355 VANDERBILT BEACH RD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2766
Mailing Address - Country:US
Mailing Address - Phone:239-514-2211
Mailing Address - Fax:
Practice Address - Street 1:2355 VANDERBILT BEACH RD
Practice Address - Street 2:SUITE 146
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2766
Practice Address - Country:US
Practice Address - Phone:239-514-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM22276225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty