Provider Demographics
NPI:1841850146
Name:MEISTER MASSAGE
Entity type:Organization
Organization Name:MEISTER MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:720-633-4138
Mailing Address - Street 1:1118 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-4018
Mailing Address - Country:US
Mailing Address - Phone:720-633-4138
Mailing Address - Fax:
Practice Address - Street 1:114 W 3RD ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-5914
Practice Address - Country:US
Practice Address - Phone:720-633-4138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty