Provider Demographics
NPI:1063275121
Name:COMPETITOR'S EDGE MASSAGE LLC
Entity type:Organization
Organization Name:COMPETITOR'S EDGE MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MMT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MMT
Authorized Official - Phone:479-276-1651
Mailing Address - Street 1:2140 N COLLEGE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2843
Mailing Address - Country:US
Mailing Address - Phone:479-276-1651
Mailing Address - Fax:
Practice Address - Street 1:2140 N COLLEGE AVE STE 4
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2843
Practice Address - Country:US
Practice Address - Phone:479-276-1651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty