Provider Demographics
NPI:1467877837
Name:NO KNOTS THERAPEUTIC MASSAGE
Entity Type:Organization
Organization Name:NO KNOTS THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERLOOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-539-9298
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53050-0085
Mailing Address - Country:US
Mailing Address - Phone:920-539-8289
Mailing Address - Fax:
Practice Address - Street 1:976 E JOHNSON ST STE 900
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-9747
Practice Address - Country:US
Practice Address - Phone:920-539-8289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3047-146225700000X
WI10816-146225700000X
WI4559-146225700000X
WI2742-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty