Provider Demographics
NPI:1225350127
Name:CENTER FOR THERAPEUTIC MASSAGE
Entity Type:Organization
Organization Name:CENTER FOR THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:BS, LMT
Authorized Official - Phone:843-852-9939
Mailing Address - Street 1:1064 GARDNER RD
Mailing Address - Street 2:SUITE 1064
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5768
Mailing Address - Country:US
Mailing Address - Phone:843-852-9939
Mailing Address - Fax:843-852-9949
Practice Address - Street 1:45 COURTENAY DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1117
Practice Address - Country:US
Practice Address - Phone:843-852-9939
Practice Address - Fax:843-852-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5437172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty