Organization
MASSAGE FOR ATHLETES, INC.
Active
Other names
Massage For Atheltes Sports & Medical Massage
Organization subpart
No
Provider details
NPI number
Authorized official
CORALIE JENNER (OWNER/CEO)
(707) 541-6258
Entity
Organization
Contact information
Practice address
418 AVIATION BLVD STE D, SANTA ROSA, CA 95403-1074
(707) 541-6258
(707) 284-0122
Mailing address
418 AVIATION BLVD STE D, SANTA ROSA, CA 95403-1074
(707) 541-6258
(707) 284-0122
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
174H00000X
Health Educator
—
—
225700000X
Massage Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
05/18/2021
Last updated
07/01/2021
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