Provider Demographics
NPI:1083349351
Name:NATURES REMEDY LLC
Entity Type:Organization
Organization Name:NATURES REMEDY LLC
Other - Org Name:NATURE'S REMEDY DAY SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING MANAGER/MEDICAL MASSAGE
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT MMP
Authorized Official - Phone:260-306-3057
Mailing Address - Street 1:121 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MANCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46962-1822
Mailing Address - Country:US
Mailing Address - Phone:260-306-3057
Mailing Address - Fax:
Practice Address - Street 1:121 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH MANCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46962-1822
Practice Address - Country:US
Practice Address - Phone:260-306-3057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1801387352OtherMEDICAL MASSAGE CERTIFICATION