Provider Demographics
NPI:1497629166
Name:RESTORATIVE MEDICAL MASSAGE LLC
Entity type:Organization
Organization Name:RESTORATIVE MEDICAL MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MCGINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CLT, PTA
Authorized Official - Phone:402-469-8320
Mailing Address - Street 1:5611 NW 1ST ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4469
Mailing Address - Country:US
Mailing Address - Phone:402-417-0781
Mailing Address - Fax:
Practice Address - Street 1:5611 NW 1ST ST STE 102
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4469
Practice Address - Country:US
Practice Address - Phone:402-417-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty