Provider Demographics
NPI:1518390301
Name:THERAPEUTIC MASSAGE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:THERAPEUTIC MASSAGE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CORA
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:MINICH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CMMP
Authorized Official - Phone:419-355-8440
Mailing Address - Street 1:510 COURT ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-2408
Mailing Address - Country:US
Mailing Address - Phone:419-355-8440
Mailing Address - Fax:
Practice Address - Street 1:510 COURT ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2408
Practice Address - Country:US
Practice Address - Phone:419-355-8440
Practice Address - Fax:419-355-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
021029225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty