Provider Demographics
NPI:1003018409
Name:INNER SPA LLC
Entity Type:Organization
Organization Name:INNER SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-968-9000
Mailing Address - Street 1:4 TERRY DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1838
Mailing Address - Country:US
Mailing Address - Phone:215-968-9000
Mailing Address - Fax:
Practice Address - Street 1:4 TERRY DR
Practice Address - Street 2:SUITE 12
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:215-968-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Multi-Specialty