Provider Demographics
NPI:1407679905
Name:MASSAGE RX LLC
Entity type:Organization
Organization Name:MASSAGE RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CROAK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:614-218-5512
Mailing Address - Street 1:393 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3082
Mailing Address - Country:US
Mailing Address - Phone:614-218-5512
Mailing Address - Fax:
Practice Address - Street 1:387 COUNTY LINE RD W STE 225
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6918
Practice Address - Country:US
Practice Address - Phone:614-218-5512
Practice Address - Fax:614-882-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty