MYSTIC PARADISE LLC (NPI# 1396222485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396222485 |
| Entity Type | Organization |
| Organization Name | MYSTIC PARADISE LLC |
| Practice Address |
1765 Us Route 60 Hurricane WV 25526-2552 |
| Mailing Address |
Rr 3 Box 308a Milton WV 25541-9518 |
| Practice Telephone | 3046382113 |
| Mailing Telephone | 3046382113 |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | VIRGINIA CHRISTINE SHILTZ (MEMBER/MASSAGE THERAPIST) |
| Authorized Official Telephone | 3046382113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1765 US ROUTE 60 |
| City | HURRICANE |
| State | WV |
| Zip Code | 25526-2552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081707 | Paige E Walroth | Technician | 51 Overlook Dr, Hurricane, WV 25526 | 2020-10-21 |
| 1770195778 | Marilyn Sue Shank | Technician | 168 Willow Tree Way, Apt 313, Hurricane, WV 25526 | 2020-08-20 |
| 1275150351 | Wv Wellness and Recovery LLC | Clinic/Center | 4 Putnam Village Drive, Hurricane, WV 25526 | 2020-07-06 |
| 1538645718 | Patsy Samples | Technician | 3067 State Rt 34s, Hurricane, WV 25526 | 2018-07-11 |
| 1528550274 | Sarah Marie Jackson | Occupational Therapist | Genesis-putnam Center, 300 Seville Road, Hurricane, WV 25526 | 2018-05-30 |
| 1619466463 | Mh Psychological Services, Pllc | Psychologist | 125 Morris Ct, Hurricane, WV 25526 | 2018-05-08 |
| 1023510740 | William Riddle | Technician | 157 Washington Cirlce, Hurricane, WV 25526 | 2018-03-08 |
| 1942702303 | Natalie Whitman | Technician | 2933 State Route 34 South, Hurricane, WV 25526 | 2018-03-01 |
| 1972002681 | Dianna Roberts | Technician | 550 Dudding Avenue, Hurricane, WV 25526 | 2018-02-08 |
| 1174022875 | Nancy Adams | Technician | 1 Western Hills Drive, Hurricane, WV 25526 | 2018-02-08 |
| Find all providers in zip 25526 | ||||
| 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 |
|---|---|---|---|---|
| 1770963043 | Robin Charlene Collins | Massage Therapist | 79 Lakeside Dr, Hurricane, WV 25526-9776 | 2015-06-02 |
| 1679877088 | Cynthia Macdonald Hedden | Massage Therapist | 1120 W 3940 S, Hurricane, UT 84737-2669 | 2010-12-28 |
| 1730705906 | Robin Black | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2020-06-23 |
| 1316485501 | Christy Wolfe | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2017-02-07 |
| 1609313493 | Ronda Lyn Sergent | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2017-01-31 |
| 1841693017 | Tamara R Cline | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2014-10-02 |
| 1528467560 | Therapeutic Massage | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2014-08-15 |
| 1952700056 | Sara Sampson | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2014-08-14 |
| 1932533429 | Holly Hoffmann | Massage Therapist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2013-09-03 |
| 1114175601 | Sara Adkins | Massage Therapist | 3910 Teays Valley Rd, Hurricane, WV 25526-9756 | 2008-09-09 |
| Find all providers in HURRICANE | ||||
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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.