Provider Demographics
NPI:1013313097
Name:COMPASSION MASSAGE THERAPEUTIC CLINIC
Entity Type:Organization
Organization Name:COMPASSION MASSAGE THERAPEUTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND LMT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHRINE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:THIBAULT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:978-534-0101
Mailing Address - Street 1:1137 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1753
Mailing Address - Country:US
Mailing Address - Phone:978-534-0101
Mailing Address - Fax:978-534-0188
Practice Address - Street 1:1137 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1753
Practice Address - Country:US
Practice Address - Phone:978-534-0101
Practice Address - Fax:978-534-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1064225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty