A Natural Massage

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

01531 Issued in AZ

Legal business name

A NATURAL MASSAGE

Practice address

2178 McCulloch Blvd N
Suite 12
Lake Havasu City, AZ 86403-6864

Phone

(928) 505-8667

Fax

(928) 505-2300

NPI assigned

Jun 30, 2015

Last updated

Jun 30, 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

Jack G Rogerson, NCTMB

Title

Owner

Phone

(928) 505-8667

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1437532116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2178 MCCULLOCH BLVD N",
            "address_2": "SUITE 12",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036864",
            "telephone_number": "928-505-8667",
            "fax_number": "928-505-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2178 MCCULLOCH BLVD N",
            "address_2": "SUITE 12",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036864",
            "telephone_number": "928-505-8667",
            "fax_number": "928-505-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A NATURAL MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "ROGERSON",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-505-8667",
        "authorized_official_credential": "NCTMB"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "AZ",
            "license": "01531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mechanotherapist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Mechanotherapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.