Provider Demographics
NPI:1417657115
Name:MASSAGE ART STUDIO LLC
Entity Type:Organization
Organization Name:MASSAGE ART STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DASHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:404-438-6154
Mailing Address - Street 1:8400 GLENWOODS TER
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-4313
Mailing Address - Country:US
Mailing Address - Phone:678-860-8418
Mailing Address - Fax:
Practice Address - Street 1:2836 LAVISTA RD STE D
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1301
Practice Address - Country:US
Practice Address - Phone:404-438-6154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty