Matthew Russell Lindholm
Individual provider Active NPI Massage Therapist · Villas, NJ
NPI 1235865411 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1235865411
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 18KT01441000 (NJ)
- Practice address
- 122 Edna Ave
Villas, NJ 08251-1324 - Phone
- (609) 425-9075
- NPI assigned
- Jul 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18KT01441000 | NJ | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | 18KT01441000 | NJ | Yes |
Addresses
Primary practice location
122 Edna Ave
Villas, NJ 08251-1324
Mailing address
122 Edna Ave
Villas, NJ 08251-1324
Phone (609) 425-9075
Other providers in Villas, NJ
- Joyce Hand
- Jennifer Hickok
- Thomas Patrick Hoban
- Katherine Elizabeth Jones
- Linda Louise Kampmeier
- Joanna Heather Little
- Jon Little
- Lower Township Rescue Squad
- Heather Lucadema
- Kelsy Lucas
All providers in Villas, NJ · Massage Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.