Provider Demographics
NPI:1205230612
Name:MASSAGE FITNESS, LLC
Entity Type:Organization
Organization Name:MASSAGE FITNESS, LLC
Other - Org Name:MASSAGE FITNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:719-231-3081
Mailing Address - Street 1:4475 STONEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4897
Mailing Address - Country:US
Mailing Address - Phone:719-231-3081
Mailing Address - Fax:
Practice Address - Street 1:1255 LAKE PLAZA DR
Practice Address - Street 2:SUITE 268
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3500
Practice Address - Country:US
Practice Address - Phone:719-231-3081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004653225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty