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CCM MASSAGE THERAPYLLC NPI 1912515974


NPI Information

NPI: 1912515974
Provider Name: CCM MASSAGE THERAPY,LLC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Address:
606 COUNTRY LN
TWIN LAKES, WI
ZIP 53181
Phone: (262) 684-9466
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CCM MASSAGE THERAPY,LLC is a massage therapist in Twin Lakes, WI. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. CCM MASSAGE THERAPY,LLC NPI is 1912515974. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

606 COUNTRY LN
TWIN LAKES, WI
ZIP 53181-502
Phone: (262) 684-9466
Fax: (262) 279-2214

The provider's authorized official is Christine Gerling-lmt .
The authorized official title is Owner/massage Therapist and has the following contact phone number (262) 684-9466.

The enumeration date for this NPI number is 7/16/2020 and was last updated on 9/9/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225700000XMassage TherapistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11720647803MEDICAIDWISCONSIN
21912515974MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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