Provider Demographics
NPI:1992077531
Name:MASSAGE GEEK LLC
Entity type:Organization
Organization Name:MASSAGE GEEK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICIA
Authorized Official - Suffix:
Authorized Official - Credentials:NCTMB
Authorized Official - Phone:612-325-3357
Mailing Address - Street 1:2375 UNIVERSITY AVE W STE 160
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1632
Mailing Address - Country:US
Mailing Address - Phone:612-325-3357
Mailing Address - Fax:
Practice Address - Street 1:2375 UNIVERSITY AVE W STE 160
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1632
Practice Address - Country:US
Practice Address - Phone:612-325-3357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-28
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty