Provider Demographics
NPI:1467752741
Name:HOPE WITHIN MASSAGE CENTER
Entity Type:Organization
Organization Name:HOPE WITHIN MASSAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEA
Authorized Official - Middle Name:RM
Authorized Official - Last Name:THIBEAULT
Authorized Official - Suffix:
Authorized Official - Credentials:PMT
Authorized Official - Phone:570-497-4766
Mailing Address - Street 1:308 W 36TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-2803
Mailing Address - Country:US
Mailing Address - Phone:570-497-4766
Mailing Address - Fax:570-245-3899
Practice Address - Street 1:308 W 36TH ST STE 125
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-2803
Practice Address - Country:US
Practice Address - Phone:570-497-4766
Practice Address - Fax:570-245-3899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty