Provider Demographics
NPI:1740162155
Name:MIND INFLUENCE LLC
Entity type:Organization
Organization Name:MIND INFLUENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MASSAGE THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:470-262-6460
Mailing Address - Street 1:3475 N DESERT DR STE 1104
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-5723
Mailing Address - Country:US
Mailing Address - Phone:470-262-6460
Mailing Address - Fax:
Practice Address - Street 1:3475 N DESERT DR STE 1104
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-5723
Practice Address - Country:US
Practice Address - Phone:470-262-6460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty