Organization Name: | BODY WELLNESS LLC |
NPI Number: | 1194060020 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT JAPHET (OWNER) |
Mailing Address: | 463 Turner Dr Ste 104b Durango |
State: | CO US |
Postal Code: | 813037981 |
Phone Number: | 9709460292 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2012 |
NPI Last Update Date: | 05/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 10805 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
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. |