MASSAGE REVOLUTION NPI 1053754580

NPI Information

  • NPI: 1053754580
  • Provider Name: MASSAGE REVOLUTION
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 210 E CAPITOL ST
    STE M-142
    JACKSON, MS
    ZIP 39201
  • Phone: (601) 918-1853

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NPI Details

MASSAGE REVOLUTION is a specialist in Jackson, MS. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MASSAGE REVOLUTION NPI is 1053754580. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

210 E CAPITOL ST
STE M-142
JACKSON, MS
ZIP 39201-306
Phone: (601) 918-1853

The provider's authorized official is Laura Manning .
The authorized official title is Partner/owner and has the following contact phone number (601) 918-1853.

The enumeration date for this NPI number is 4/15/2013 and was last updated on 4/15/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistLMT 2025MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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