Provider Demographics
NPI:1740439439
Name:AT HOME MASSAGE THERAPY INC.
Entity type:Organization
Organization Name:AT HOME MASSAGE THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHIRK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:561-271-6611
Mailing Address - Street 1:241 POE DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-1912
Mailing Address - Country:US
Mailing Address - Phone:561-271-6611
Mailing Address - Fax:
Practice Address - Street 1:241 POE DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-1912
Practice Address - Country:US
Practice Address - Phone:561-271-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA2917251E00000X
FLMA 35937251E00000X
FLMA53642251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health