Organization Name: | FIRESIDE MASSAGE |
NPI Number: | 1225415250 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLY ANN SKLODOWSKI (LICENCED MASSAGE THERAPIST) |
Mailing Address: | 110 Keystone Ave Cresson |
State: | PA US |
Postal Code: | 166301213 |
Phone Number: | 8149329669 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2015 |
NPI Last Update Date: | 04/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | MSG003985 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |