Provider Demographics
NPI:1295491751
Name:ASHLAND INSTITUTE OF MASSAGE INC
Entity type:Organization
Organization Name:ASHLAND INSTITUTE OF MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:PROFFITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-482-5134
Mailing Address - Street 1:PO BOX 1233
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-0042
Mailing Address - Country:US
Mailing Address - Phone:541-482-5134
Mailing Address - Fax:
Practice Address - Street 1:280 E HERSEY ST STE B17
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1293
Practice Address - Country:US
Practice Address - Phone:541-482-5134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLAND INSTITUTE OF MASSAGE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-09
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty