Provider Demographics
NPI:1659731438
Name:ULTIMATE TOUCH MASSAGE THERAPY
Entity Type:Organization
Organization Name:ULTIMATE TOUCH MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:UHL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:859-539-3350
Mailing Address - Street 1:71 CAVALIER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5121
Mailing Address - Country:US
Mailing Address - Phone:859-539-3350
Mailing Address - Fax:859-341-3942
Practice Address - Street 1:71 CAVALIER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5121
Practice Address - Country:US
Practice Address - Phone:859-539-3350
Practice Address - Fax:859-341-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3620302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY-3620OtherLICENSE NUMBER