Provider Demographics
NPI:1518739911
Name:PREMIER MASSAGE CARE & SERVICES LLC
Entity Type:Organization
Organization Name:PREMIER MASSAGE CARE & SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMT
Authorized Official - Prefix:
Authorized Official - First Name:MARRA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:405-921-1308
Mailing Address - Street 1:5525 ERINDALE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6960
Mailing Address - Country:US
Mailing Address - Phone:719-362-6479
Mailing Address - Fax:719-224-9840
Practice Address - Street 1:5525 ERINDALE DR STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6960
Practice Address - Country:US
Practice Address - Phone:405-921-1308
Practice Address - Fax:719-224-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty