1164947412 NPI number — ALL ABOUT MASSAGE AND WELLNESS, LLC

Table of content: (NPI 1164947412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164947412 NPI number — ALL ABOUT MASSAGE AND WELLNESS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL ABOUT MASSAGE AND WELLNESS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164947412
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 VALLEYBROOK ROAD
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
MCMURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-3428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-420-7183
Provider Business Mailing Address Fax Number:
412-731-4836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1112 S. BRADDOCK AVENUE
Provider Second Line Business Practice Location Address:
SUITE 301D
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-420-7183
Provider Business Practice Location Address Fax Number:
412-731-4836
Provider Enumeration Date:
08/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HOWORTH KROB
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
LYNNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-941-8835

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  CW012703 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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