Provider Demographics
NPI:1245441799
Name:ESCAPE THERAPEUTIC MASSAGE INC
Entity type:Organization
Organization Name:ESCAPE THERAPEUTIC MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:850-478-2273
Mailing Address - Street 1:4400 BAYOU BLVD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2673
Mailing Address - Country:US
Mailing Address - Phone:850-478-2273
Mailing Address - Fax:850-475-1687
Practice Address - Street 1:4400 BAYOU BLVD
Practice Address - Street 2:SUITE 24
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2673
Practice Address - Country:US
Practice Address - Phone:850-478-2273
Practice Address - Fax:850-475-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM19321225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty