Provider Demographics
NPI:1740735190
Name:MASSAGE AND WELLNESS, LLC
Entity Type:Organization
Organization Name:MASSAGE AND WELLNESS, LLC
Other - Org Name:MASSAGE & WELLNESS SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSSEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT,CCA,PTA
Authorized Official - Phone:727-459-2861
Mailing Address - Street 1:118 W BAY DR
Mailing Address - Street 2:SUITE 121
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3362
Mailing Address - Country:US
Mailing Address - Phone:727-459-2861
Mailing Address - Fax:
Practice Address - Street 1:118 W BAY DR
Practice Address - Street 2:SUITE 121
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3362
Practice Address - Country:US
Practice Address - Phone:727-459-2861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23653261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy