Provider Demographics
NPI: | 1245796606 |
---|---|
Name: | NAVARRE HEALING ARTS, LLC |
Entity Type: | Organization |
Organization Name: | NAVARRE HEALING ARTS, LLC |
Other - Org Name: | NAVARRE HEALING ARTS, LLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NORMA |
Authorized Official - Middle Name: | JEAN |
Authorized Official - Last Name: | KE-A |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMT |
Authorized Official - Phone: | 850-936-5300 |
Mailing Address - Street 1: | 7552 NAVARRE PKWY UNIT 44 |
Mailing Address - Street 2: | |
Mailing Address - City: | NAVARRE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32566-7309 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7552 NAVARRE PKWY UNIT 44 |
Practice Address - Street 2: | |
Practice Address - City: | NAVARRE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32566-7309 |
Practice Address - Country: | US |
Practice Address - Phone: | 850-803-7994 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-02-11 |
Last Update Date: | 2020-01-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | Group - Multi-Specialty |