Provider Demographics
NPI:1184218109
Name:MASSAGE ESSENZ, LLC
Entity Type:Organization
Organization Name:MASSAGE ESSENZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE AND BODYWORK THERA
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMMERSON-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMBT
Authorized Official - Phone:919-698-5430
Mailing Address - Street 1:4206 N ROXBORO ST STE 130
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1868
Mailing Address - Country:US
Mailing Address - Phone:919-698-5430
Mailing Address - Fax:
Practice Address - Street 1:4206 N ROXBORO ST STE 130
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1868
Practice Address - Country:US
Practice Address - Phone:919-698-5430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty