GLENDALE SPORTS MASSAGE LLC (NPI# 1730463852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730463852 |
| Entity Type | Organization |
| Organization Name | GLENDALE SPORTS MASSAGE LLC |
| Practice Address |
6808 N Dysart Rd #136 Glendale AZ 85307-2231 |
| Practice Telephone | 6232152525 |
| Mailing Telephone | 6232152525 |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | MR. EAGLE BOWERS (OWNER) |
| Authorized Official Telephone | 6232152525 |
| Authorized Official Credential | BA, CFT,LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
6808 N DYSART RD #136 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85307-2231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154635761 | Aeroptics LLC | Optometrist | 7071 N 138th Av, Bldg 1540, Glendale, AZ 85307 | 2010-08-06 |
| 1902894579 | Daniela Nicosia | Optometrist | 7071 N 138th Ave, Luke Afb, AZ 85307 | 2005-10-07 |
| 1144633157 | Sharan Kaur Knott | Pharmacist | 10945 W Vista Ln, Glendale, AZ 85307-1645 | 2014-06-06 |
| 1841813961 | Yoshica Mitchell | Behavior Technician | 12923 W Lawrence Ct, Glendale, AZ 85307-1900 | 2020-05-22 |
| 1700328556 | Tonya Brown | Social Worker | 12912 W Mclellan Rd, Glendale, AZ 85307-1917 | 2016-11-10 |
| 1447806997 | Tamarra Kalamchi | Dentist | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-08-12 |
| 1043623648 | Dr Larsen Eye Care Inc | Optometrist | 7071 N 138th Ave # 1552, Luke Afb, AZ 85307-2006 | 2014-06-11 |
| 1619519840 | Platinum Venture Group LLC | Durable Medical Equipment & Medical Supplies | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-10-09 |
| 1710255989 | Optical Center | Technician/Technologist | 7071 N 138th Ave, Glendale, AZ 85307-2006 | 2011-12-02 |
| 1386088128 | Clifton Jamar Premo | Respiratory Therapist, Registered | 13517 W Glendale Ave, Apt 1135, Glendale, AZ 85307-2010 | 2013-04-23 |
| Find all providers in zip 85307 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628920 | Angelina Hull | Massage Therapist | 4318 W Kimberly Way, Glendale, AZ 85308-4411 | 2020-10-29 |
| 1881292035 | Chrysta Beyer | Massage Therapist | 117 W Good Hope Rd, Glendale, WI 53217-3857 | 2020-10-10 |
| 1407461403 | Netthip Kunkaew | Massage Therapist | 920 Avonoak Ter, Glendale, CA 91206-1509 | 2020-09-15 |
| 1932694213 | Michelle Anderson | Massage Therapist | 3460 Ocean View Blvd Ste B, Glendale, CA 91208-3306 | 2018-06-28 |
| 1174020440 | Kelly Marie Kolb | Massage Therapist | 6615 W Happy Valley Rd Ste B108, Glendale, AZ 85310-2608 | 2018-04-12 |
| 1851895957 | Bethanie Dawn Freshour | Massage Therapist | 4360 W Thunderbird Rd, Glendale, AZ 85306-5027 | 2018-03-22 |
| 1184126062 | Mary A Bocchicchio | Massage Therapist | 5156 W Olive Ave # 404, Glendale, AZ 85302-4205 | 2018-03-06 |
| 1508384520 | Amanda K Ong | Massage Therapist | 5334 W Northern Ave Ste 325, Glendale, AZ 85301-1441 | 2017-08-30 |
| 1619490802 | Danielle Marie Hicks | Massage Therapist | 20325 N 51st Ave Ste 108, Glendale, AZ 85308-5665 | 2017-07-20 |
| 1780036285 | Donn Belrichard | Massage Therapist | 6610 N 47th Ave Ste 5, Glendale, AZ 85301-4163 | 2016-07-07 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.