Provider Demographics
NPI:1336779800
Name:KNEAD MORE MASSAGE
Entity Type:Organization
Organization Name:KNEAD MORE MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, STNA, CMA
Authorized Official - Phone:937-404-1214
Mailing Address - Street 1:920 E SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2856
Mailing Address - Country:US
Mailing Address - Phone:937-404-1214
Mailing Address - Fax:
Practice Address - Street 1:920 E SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2856
Practice Address - Country:US
Practice Address - Phone:937-404-1214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty