Provider Demographics
NPI:1497590863
Name:MEDICAL MASSAGE PROS LLC
Entity type:Organization
Organization Name:MEDICAL MASSAGE PROS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-246-7767
Mailing Address - Street 1:250 RED CLIFFS DR STE 36
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8129
Mailing Address - Country:US
Mailing Address - Phone:435-246-7767
Mailing Address - Fax:
Practice Address - Street 1:250 RED CLIFFS DR STE 36
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8129
Practice Address - Country:US
Practice Address - Phone:435-246-7767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty