Provider Demographics
NPI:1366846834
Name:SPOT ON RELAXATION & REHABILITATION
Entity Type:Organization
Organization Name:SPOT ON RELAXATION & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SPOTA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:516-459-0179
Mailing Address - Street 1:136 RADCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1219
Mailing Address - Country:US
Mailing Address - Phone:516-459-0179
Mailing Address - Fax:
Practice Address - Street 1:136 RADCLIFFE RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1219
Practice Address - Country:US
Practice Address - Phone:516-459-0179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028241225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty