Provider Demographics
NPI:1932296902
Name:MASSAGEWORKS THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:MASSAGEWORKS THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST / PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:TOLAND
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:410-789-6550
Mailing Address - Street 1:809 N HAMMONDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1301
Mailing Address - Country:US
Mailing Address - Phone:410-789-6550
Mailing Address - Fax:410-789-6557
Practice Address - Street 1:809 N HAMMONDS FERRY RD
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-1301
Practice Address - Country:US
Practice Address - Phone:410-789-6550
Practice Address - Fax:410-789-6557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM00810225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty