Provider Demographics
NPI:1023649795
Name:MC MASSAGE THERAPY CORP
Entity type:Organization
Organization Name:MC MASSAGE THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERNAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:937-344-8770
Mailing Address - Street 1:8050 BECKETT CENTER DR STE 302
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5033
Mailing Address - Country:US
Mailing Address - Phone:937-344-8770
Mailing Address - Fax:
Practice Address - Street 1:8050 BECKETT CENTER DR STE 302
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5033
Practice Address - Country:US
Practice Address - Phone:937-344-8770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty