Provider Demographics
NPI:1740872654
Name:LAROSE MUSCULAR THERAPY, LLC
Entity type:Organization
Organization Name:LAROSE MUSCULAR THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:413-455-5747
Mailing Address - Street 1:114 WATER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3007
Mailing Address - Country:US
Mailing Address - Phone:508-478-0082
Mailing Address - Fax:
Practice Address - Street 1:114 WATER ST STE 1
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3007
Practice Address - Country:US
Practice Address - Phone:508-478-0082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty