Provider Demographics
NPI:1750708087
Name:THERAPEUTIC MASSAGE CENTER
Entity type:Organization
Organization Name:THERAPEUTIC MASSAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:614-442-6754
Mailing Address - Street 1:1840 ZOLLINGER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2850
Mailing Address - Country:US
Mailing Address - Phone:614-442-6754
Mailing Address - Fax:614-442-6737
Practice Address - Street 1:1840 ZOLLINGER RD
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2850
Practice Address - Country:US
Practice Address - Phone:614-442-6754
Practice Address - Fax:614-442-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021508172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty