Provider Demographics
NPI:1689816654
Name:PRESCIENT, LLC
Entity Type:Organization
Organization Name:PRESCIENT, LLC
Other - Org Name:MEDICAL MASSAGE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERPRETER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:BARTELS
Authorized Official - Last Name:ZIVALICH
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:612-801-5195
Mailing Address - Street 1:2920 BRYANT AVE S # 1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2195
Mailing Address - Country:US
Mailing Address - Phone:612-801-5195
Mailing Address - Fax:
Practice Address - Street 1:2920 BRYANT AVE S # 1
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2195
Practice Address - Country:US
Practice Address - Phone:612-801-5195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty