Provider Demographics
NPI:1831212018
Name:WELLNESS CENTER FOR THERAPEUTIC MASSAGE & BODYWORK
Entity type:Organization
Organization Name:WELLNESS CENTER FOR THERAPEUTIC MASSAGE & BODYWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, NCMMT, LLCC
Authorized Official - Phone:419-427-9355
Mailing Address - Street 1:825 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3003
Mailing Address - Country:US
Mailing Address - Phone:419-427-9355
Mailing Address - Fax:419-427-2902
Practice Address - Street 1:825 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3003
Practice Address - Country:US
Practice Address - Phone:419-427-9355
Practice Address - Fax:419-427-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11826225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty