Provider Demographics
NPI:1780823153
Name:MEE TYME WELLNESS & MASSAGE
Entity Type:Organization
Organization Name:MEE TYME WELLNESS & MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KOLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-292-1400
Mailing Address - Street 1:4041 W SYLVANIA AVE # LL1
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4465
Mailing Address - Country:US
Mailing Address - Phone:419-292-1400
Mailing Address - Fax:
Practice Address - Street 1:4041 W SYLVANIA AVE # LL1
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4465
Practice Address - Country:US
Practice Address - Phone:419-292-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service