Provider Demographics
NPI:1740327865
Name:NW MEDICAL MASSAGE, INC.
Entity type:Organization
Organization Name:NW MEDICAL MASSAGE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:COLLINGWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, LMT, NCMMT
Authorized Official - Phone:860-435-2219
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06068-0225
Mailing Address - Country:US
Mailing Address - Phone:860-435-2219
Mailing Address - Fax:860-435-4656
Practice Address - Street 1:15 ACADEMY STREET
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:CT
Practice Address - Zip Code:06068
Practice Address - Country:US
Practice Address - Phone:860-435-2219
Practice Address - Fax:860-435-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002729225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty