NPI 1104253285 · live from the CMS NPI Registry
Massage Revolution
Massage Therapist in Jackson, MS. National Provider Identifier 1104253285, active.
NPI record
| NPI | 1104253285 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 210 E Capitol St, Suite M-142, Jackson, MS 39201 |
| Practice phone | 601-918-1853 |
| Enumerated | October 3, 2013 |
| Last updated | October 3, 2013 |
| Authorized official | Abraham Santa Cruz, Operations Manager |
| Other names | Massage Revolution, LLC |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 2027 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.