Provider Demographics
NPI:1164082608
Name:NEW SEASONS BODYWORK, INC
Entity Type:Organization
Organization Name:NEW SEASONS BODYWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:907-903-3629
Mailing Address - Street 1:43335 KALIFORNSKY BEACH RD STE 25
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-8280
Mailing Address - Country:US
Mailing Address - Phone:907-903-3629
Mailing Address - Fax:907-262-0474
Practice Address - Street 1:43335 KALIFORNSKY BEACH RD STE 25
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8280
Practice Address - Country:US
Practice Address - Phone:907-903-3629
Practice Address - Fax:907-262-0474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center