Provider Demographics
NPI:1598102923
Name:BODY ACHE ESCAPE MASSAGE CENTER
Entity Type:Organization
Organization Name:BODY ACHE ESCAPE MASSAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MILLER COOK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:614-604-6358
Mailing Address - Street 1:1501 STONECREEK DR S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9838
Mailing Address - Country:US
Mailing Address - Phone:614-604-6358
Mailing Address - Fax:
Practice Address - Street 1:1501 STONECREEK DR S
Practice Address - Street 2:SUITE 101
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9838
Practice Address - Country:US
Practice Address - Phone:614-604-6358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.011126261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center