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Vital Living Therapeutic Massage, Llc
Massage Therapist in Fort Wayne, Indiana
NPI 1790151157

Vital Living Therapeutic Massage, Llc is a Massage Therapist based in Fort Wayne, IN. Vital Living Therapeutic Massage, Llc practices in Fort Wayne, IN. The NPI Number for Vital Living Therapeutic Massage, Llc is 1790151157 and holds a License No. 28057959A (Indiana).

The current practice location address for Vital Living Therapeutic Massage, Llc is 5111 N Bend Dr, Fort Wayne, IN and can be reached out via phone at 260-436-8807 and via fax at 260-436-2767.

Location: 5111 N Bend Dr, Fort Wayne, IN, 46804-1753
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790151157
Provider Name
Vital Living Therapeutic Massage, Llc
Credential
Provider Entity Type
Organization
Address
5111 N Bend Dr, Fort Wayne, IN, 46804-1753
Phone Number
260-436-8807
Fax Number
260-436-2767
Provider Enumeration Date
08/19/2015
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
5111 N Bend Dr
City
Fort Wayne
State
Indiana
Zip
46804-1753
Phone Number
260-436-8807
Fax Number
260-436-2767
person
Provider Business Mailing Address Details
Address
5111 N Bend Dr
City
Fort Wayne
State
Indiana
Zip
46804-1753
Phone Number
260-436-8807
Fax Number
260-436-2767
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Nurse Massage Therapist (NMT)
Taxonomy
163WM1400X
License No.
MT20901877 (Indiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
28057959A (Indiana)
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.
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