Southeastern Neuromuscular Massage Therapy, Inc.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT003853 Issued in GA

Legal business name

SOUTHEASTERN NEUROMUSCULAR MASSAGE THERAPY, INC.

Practice address

112 Madison Ave N
Douglas, GA 31533-4604

Phone

(912) 383-4934

Fax

(912) 383-4934

NPI assigned

Aug 15, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth G. Stevens

Title

Therapist

Phone

(912) 383-4934

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1821345356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N. MADISON AVE.",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "31533",
            "telephone_number": "912-383-4934",
            "fax_number": "912-383-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MADISON AVE N",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315334604",
            "telephone_number": "912-383-4934",
            "fax_number": "912-383-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN NEUROMUSCULAR MASSAGE THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "912-383-4934",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT003853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Douglas, GA
• Providers in Douglas, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.