Provider Demographics
NPI:1215489216
Name:HEALING HANDS MEDICAL MASSAGE LLC.
Entity type:Organization
Organization Name:HEALING HANDS MEDICAL MASSAGE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MEDICAL MASSAGE PRAC
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:615-904-5311
Mailing Address - Street 1:9916 HARRISON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-6615
Mailing Address - Country:US
Mailing Address - Phone:615-904-5311
Mailing Address - Fax:
Practice Address - Street 1:477 N CHANCERY ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-8901
Practice Address - Country:US
Practice Address - Phone:931-473-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1589225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty