Provider Demographics
NPI:1326251257
Name:CONCEPTS IN MASSAGE THERAPY & BODYWORK LTD.
Entity Type:Organization
Organization Name:CONCEPTS IN MASSAGE THERAPY & BODYWORK LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:651-389-1016
Mailing Address - Street 1:444 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55075-2510
Mailing Address - Country:US
Mailing Address - Phone:651-389-1016
Mailing Address - Fax:
Practice Address - Street 1:820 CONCORD ST N STE 104
Practice Address - Street 2:
Practice Address - City:SOUTH SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1121
Practice Address - Country:US
Practice Address - Phone:651-389-1016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center