Provider Demographics
NPI:1881194967
Name:CINCINNATI MUSCLE THERAPY LLC
Entity Type:Organization
Organization Name:CINCINNATI MUSCLE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:LATONYA
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:513-208-3564
Mailing Address - Street 1:6240 HAMILTON AVE STE 6D
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-2000
Mailing Address - Country:US
Mailing Address - Phone:513-208-3564
Mailing Address - Fax:
Practice Address - Street 1:6240 HAMILTON AVE STE 6D
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-2000
Practice Address - Country:US
Practice Address - Phone:513-208-3564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty