Provider Demographics
NPI:1295063535
Name:WEST ORANGE MASSAGE THERAPY LLC
Entity type:Organization
Organization Name:WEST ORANGE MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:E
Authorized Official - Last Name:TORNATORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:407-965-1892
Mailing Address - Street 1:1218 WINTER GARDEN VINELAND RD STE 124
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-6370
Mailing Address - Country:US
Mailing Address - Phone:407-965-1892
Mailing Address - Fax:
Practice Address - Street 1:1218 WINTER GARDEN VINELAND RD STE 124
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6370
Practice Address - Country:US
Practice Address - Phone:407-965-1892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM23884173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173C00000XOther Service ProvidersReflexologistGroup - Single Specialty