Provider Demographics
NPI:1154141307
Name:MASTERS MEDICAL MASSAGE LLC
Entity type:Organization
Organization Name:MASTERS MEDICAL MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-292-3281
Mailing Address - Street 1:1680 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2306
Mailing Address - Country:US
Mailing Address - Phone:541-292-3281
Mailing Address - Fax:
Practice Address - Street 1:27 CRATER LAKE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7444
Practice Address - Country:US
Practice Address - Phone:541-292-3281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASTERS MEDICAL MASSAGE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty