Provider Demographics
NPI:1619796596
Name:AMY MASSAGE WORKS, LLC
Entity type:Organization
Organization Name:AMY MASSAGE WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-480-5315
Mailing Address - Street 1:2220 KLIEGEL LN
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-8386
Mailing Address - Country:US
Mailing Address - Phone:573-480-5315
Mailing Address - Fax:
Practice Address - Street 1:2220 KLIEGEL LN
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-8386
Practice Address - Country:US
Practice Address - Phone:573-480-5315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty