Provider Demographics
NPI:1265971980
Name:HEALING ESSENCE MASSAGE THERAPY LLC
Entity type:Organization
Organization Name:HEALING ESSENCE MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:405-395-4151
Mailing Address - Street 1:2302 N HARRISON ST STE D
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3150
Mailing Address - Country:US
Mailing Address - Phone:405-395-4151
Mailing Address - Fax:405-395-4151
Practice Address - Street 1:2302 N HARRISON ST STE D
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-3150
Practice Address - Country:US
Practice Address - Phone:405-395-4151
Practice Address - Fax:405-395-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty