Kristen Grella

Individual provider Active NPI Massage Therapist · Edgartown, MA

NPI 1508404450 · NPPES record last updated Dec 11, 2019

Key facts

NPI
1508404450
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
Practice address
238 Edgartown Vineyard Haven Road
Edgartown, MA 02539
Phone
(508) 693-3800
Fax
(508) 693-7473
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Vineyard Complementary Medicine Inc. Massage Therapist Past
since Dec 15, 2019
Accepting new patients
Vineyard Complementary Medicine, Inc Past
since Dec 15, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Yes

Addresses

Primary practice location

238 Edgartown Vineyard Haven Road
Edgartown, MA 02539

Mailing address

PO Box 2016
Vineyard Haven, MA 02568
Phone (508) 685-2607

Other providers in Edgartown, MA

All providers in Edgartown, MA · Massage Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.