NPIMap

Organization Active NPI

Defiance Therapeutic Massage & Wellness Center, LLC

  • Specialist
  • Defiance, OH
National Provider Identifier
1003117441
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
33.014099 Issued in OH
Legal business name
DEFIANCE THERAPEUTIC MASSAGE & WELLNESS CENTER, LLC
Practice address
8081 Adams Ridge Rd
Defiance, OH 43512-9173
Phone
(419) 497-2112
Fax
(419) 497-2114
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Carrie Radzik, ATC, LMTNPI 1902165657
Title
Owner/ Director
Phone
(419) 497-2112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 65.000157 OH
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 33.014099 OH Primary

Addresses

Primary practice location

8081 Adams Ridge Rd
Defiance, OH 43512-9173

Mailing address

8081 Adams Ridge Rd
Defiance, OH 43512
Phone (419) 497-2112

National Provider Directory

National Provider Directory

Locations

8081 Adams Ridge Rd
Defiance, OH 43512
Phone (419) 239-2113

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1003117441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 ADAMS RIDGE RD",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "43512",
            "telephone_number": "419-497-2112",
            "fax_number": "419-497-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 ADAMS RIDGE RD",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435129173",
            "telephone_number": "419-497-2112",
            "fax_number": "419-497-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFIANCE THERAPEUTIC MASSAGE & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "RADZIK",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OWNER/ DIRECTOR",
        "authorized_official_telephone_number": "419-497-2112",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ATC, LMT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OH",
            "license": "65.000157",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "33.014099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.