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Organization

DAVE OLDENHAGE MASSAGE & BODYWORK, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVE OLDENHAGE BS, LMT, NCBTMB (OWNER)
(845) 634-8822
Entity
Organization

Contact information

Practice address
180 PHILLIPS HILL RD, BUILDING 1, NEW CITY, NY 10956-4132
(845) 634-8822
(845) 634-8823
Mailing address
180 PHILLIPS HILL RD, BUILDING 1, NEW CITY, NY 10956-4132
(845) 634-8822
(845) 634-8823

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022500
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022500
NEW YORK STATE MASSAGE THERAPY LICENSE
NY
01
6738738
NEW YORK STATE EDUCATION DEPARTMENT REGISTRATION CERTIFICATE
NY
Enumeration date
01/29/2010
Last updated
01/29/2010
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