Provider Demographics
NPI:1407109887
Name:CRYO SPA NATURAL HEALING CENTER
Entity Type:Organization
Organization Name:CRYO SPA NATURAL HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALENDAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-360-1493
Mailing Address - Street 1:202 HOLLAND RD STE 230
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1703
Mailing Address - Country:US
Mailing Address - Phone:215-355-3929
Mailing Address - Fax:
Practice Address - Street 1:202 HOLLAND RD STE 230
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-1703
Practice Address - Country:US
Practice Address - Phone:215-355-3929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty