Provider Demographics
NPI:1316660236
Name:STEVENSON THERAPEUTIC MASSAGE LLC
Entity type:Organization
Organization Name:STEVENSON THERAPEUTIC MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MMP, LMT, CPT
Authorized Official - Phone:215-528-4490
Mailing Address - Street 1:1000 N YORK RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1326
Mailing Address - Country:US
Mailing Address - Phone:215-528-4490
Mailing Address - Fax:
Practice Address - Street 1:1000 N YORK RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1326
Practice Address - Country:US
Practice Address - Phone:215-528-4490
Practice Address - Fax:201-603-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty