Organization Name: | COLI SUN LMT LLC |
NPI Number: | 1902078918 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICOLE ALISE SUMMERS (LICENSED MASSAGE THERAPIST) |
Mailing Address: | 855 East 260th Euclid |
State: | OH US |
Postal Code: | 441322534 |
Phone Number: | 2162618347 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2008 |
NPI Last Update Date: | 07/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 15961 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |