Provider Demographics
NPI:1134525793
Name:WHOLE HEALTH MASSAGE LLC
Entity type:Organization
Organization Name:WHOLE HEALTH MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-459-2000
Mailing Address - Street 1:8800 E POINT DOUGLAS RD S
Mailing Address - Street 2:SUITE 500
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4159
Mailing Address - Country:US
Mailing Address - Phone:651-459-2000
Mailing Address - Fax:844-270-8025
Practice Address - Street 1:8800 E POINT DOUGLAS RD S
Practice Address - Street 2:SUITE 500
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4159
Practice Address - Country:US
Practice Address - Phone:651-459-2000
Practice Address - Fax:844-270-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty