Provider Demographics
NPI:1538988787
Name:MASSAGE MOVEMENT AND WELLNESS, INC.
Entity type:Organization
Organization Name:MASSAGE MOVEMENT AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMERTON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:716-861-5100
Mailing Address - Street 1:21 CHAMBERLIN DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-2611
Mailing Address - Country:US
Mailing Address - Phone:716-861-5100
Mailing Address - Fax:
Practice Address - Street 1:5640 MAELOU DR
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-3712
Practice Address - Country:US
Practice Address - Phone:716-861-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASSAGE MOVEMENT AND WELLNESS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-05
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service