Organization Name: | BODY HARMONY MASSAGE |
NPI Number: | 1457522518 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARISA ELLEN WUNDERLICH (OWNER) |
Mailing Address: | 1002 1st St Cheney |
State: | WA US |
Postal Code: | 990041708 |
Phone Number: | 5094751238 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2008 |
NPI Last Update Date: | 03/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | MA00025203 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |