Provider Demographics
NPI:1235870833
Name:OPTIMIZE MASSAGE THERAPY, LLC
Entity Type:Organization
Organization Name:OPTIMIZE MASSAGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:228-217-0983
Mailing Address - Street 1:7019 SW 44TH AVE APT B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-6611
Mailing Address - Country:US
Mailing Address - Phone:228-217-0983
Mailing Address - Fax:
Practice Address - Street 1:7019 SW 44TH AVE APT B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-6611
Practice Address - Country:US
Practice Address - Phone:228-217-0983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty