Fresno Kinetic Bodyworks

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

61093 Issued in CA

Legal business name

FRESNO KINETIC BODYWORKS

Practice address

336 W Bedford Ave
Suite 108
Fresno, CA 93711-6185

Phone

(559) 492-6848

NPI assigned

Apr 22, 2015

Last updated

Apr 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael David Greene, CMTNPI 1568867117

Title

Owner/Therapist

Phone

(559) 492-6848

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Greene, CMT, CMMP

  • Massage Therapist
  • Fresno, CA
  • NPI 1568867117
  Authorized official Same address or phone

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1073900627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W BEDFORD AVE",
            "address_2": "SUITE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116185",
            "telephone_number": "559-492-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W BEDFORD AVE",
            "address_2": "SUITE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116185",
            "telephone_number": "559-492-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO KINETIC BODYWORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "559-492-6848",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "61093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresno Imaging Center
• Fresno Imaging Center
• Fresno Inclusive Foundation
• Fresno Institute of Neuroscience, Inc
• Fresno Interdenominational Refugee Ministries
• Fresno Kings Madera Regional Health Authority (CalViva Health)
• Fresno Long Term Care Medical Group Inc.
• Fresno Medical Center Inc (N/a)
• Fresno Medical Supply, Inc.
• Fresno Medical Transportation, LLC

• Massage Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.