Massage Therapy Clinc

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

MASSAGE THERAPY CLINC

Practice address

6409 Georgetown North Blvd
Fort Wayne, IN 46815-7007

Phone

(260) 492-9999

Fax

(260) 969-1105

NPI assigned

Nov 19, 2012

Last updated

Nov 19, 2012By 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

Mrs. Kathleen Sue Jalae-Brown

Title

Ceo

Phone

(260) 492-9999

Specialties & licenses 1

Addresses

Tax ID family

Massage Therapy Clinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Muscle Therapy Clinic LLC

  • Massage Therapist
  • Fort Wayne, IN
  • NPI 1720294432
  NPD tax ID

Locations

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1841534526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6409 GEORGETOWN NORTH BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157007",
            "telephone_number": "260-492-9999",
            "fax_number": "260-492-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6409 GEORGETOWN NORTH BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157007",
            "telephone_number": "260-492-9999",
            "fax_number": "260-969-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSAGE THERAPY CLINC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "JALAE-BROWN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-492-9999",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari A Mason, SLP
• Laynie Lyn Mason, PA-C
• Rebecca Mason, MD
• Thomas Michael Mason
• Autumn Masoner, RBT
• Massage Works Therapy Center LLC
• Jerome D. Massenburg, M.D.
• Kara Massey
• Deanna L. Massie, CNS
• Kathy Massonne, LCSW

• Massage Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Massage Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.