Provider Demographics
NPI:1255098646
Name:MUSCLE AND LYMPH MASSAGE THERAPY LLC
Entity type:Organization
Organization Name:MUSCLE AND LYMPH MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KARIANNE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:BECHTEL-UNEKIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:616-294-0063
Mailing Address - Street 1:90 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4119
Mailing Address - Country:US
Mailing Address - Phone:616-294-0063
Mailing Address - Fax:
Practice Address - Street 1:12330 JAMES ST STE B60
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8579
Practice Address - Country:US
Practice Address - Phone:616-294-0063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-20
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty