Organization
ATHLETIC EDGE SPORTS MASSAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE A SWEENEY LMT (OWNER)
(571) 259-4154
Entity
Organization
Contact information
Practice address
226 MAPLE AVE W STE 303, VIENNA, VA 22180-5607
(571) 259-4154
Mailing address
226 MAPLE AVE W STE 303, VIENNA, VA 22180-5607
(703) 938-0315
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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