Provider Demographics
NPI:1861926594
Name:INTHERA MASSOTHERAPY LLC
Entity type:Organization
Organization Name:INTHERA MASSOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LMT
Authorized Official - Phone:234-788-9738
Mailing Address - Street 1:231 SPRINGSIDE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4541
Mailing Address - Country:US
Mailing Address - Phone:234-788-9783
Mailing Address - Fax:
Practice Address - Street 1:231 SPRINGSIDE DR STE 120
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-4541
Practice Address - Country:US
Practice Address - Phone:234-788-9783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTHERA MASSOTHERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-19
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021489225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty