Organization
MATRIX MYOFASCIAL
Active
Organization
MATRIX MYOFASCIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE NATHANIEL MOSER LMT, CPMT II, CIMT (CHIEF THERAPIST & CLINICAL DIRECTOR)
(413) 522-0658
Entity
Organization
Contact information
Practice address
187 RUSSELL ST, HADLEY, MA 01035-9521
(413) 522-0658
Mailing address
678 BERNARDSTON RD, GREENFIELD, MA 01301-1104
(413) 522-0658
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9911-MT-MT
MA
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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