Provider Demographics
NPI:1891466058
Name:ELBOW GREASE MASSAGE STUDIO INC
Entity Type:Organization
Organization Name:ELBOW GREASE MASSAGE STUDIO INC
Other - Org Name:ELBOW GREASE MASSAGE STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WESO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:920-395-4841
Mailing Address - Street 1:2830 CURRY CT STE 3
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4877
Mailing Address - Country:US
Mailing Address - Phone:920-395-4841
Mailing Address - Fax:920-301-6442
Practice Address - Street 1:2830 CURRY CT STE 3
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4877
Practice Address - Country:US
Practice Address - Phone:920-395-4841
Practice Address - Fax:920-301-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty