Provider Demographics
NPI:1669483491
Name:FLOYDS KNOBS THERAPEUTIC MASSAGE CLINIC, INC
Entity Type:Organization
Organization Name:FLOYDS KNOBS THERAPEUTIC MASSAGE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOI
Authorized Official - Suffix:
Authorized Official - Credentials:NCTMB, CMT
Authorized Official - Phone:912-948-2799
Mailing Address - Street 1:3523 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9751
Mailing Address - Country:US
Mailing Address - Phone:812-948-2799
Mailing Address - Fax:812-948-2769
Practice Address - Street 1:3523 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9751
Practice Address - Country:US
Practice Address - Phone:812-948-2799
Practice Address - Fax:812-948-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty