Provider Demographics
NPI:1740568682
Name:KNEADING TOUCH MASSAGE THERAPY
Entity Type:Organization
Organization Name:KNEADING TOUCH MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONALLY CERTIFIED MASSAGE THERAP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:717-642-5903
Mailing Address - Street 1:3144 FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-7325
Mailing Address - Country:US
Mailing Address - Phone:717-642-5903
Mailing Address - Fax:717-642-5903
Practice Address - Street 1:3144 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7325
Practice Address - Country:US
Practice Address - Phone:717-642-5903
Practice Address - Fax:717-642-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG002183225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty