Provider Demographics
NPI:1467695825
Name:VISIONS MASSAGE & BODYWORK LLC
Entity Type:Organization
Organization Name:VISIONS MASSAGE & BODYWORK LLC
Other - Org Name:VISIONS MASSAGE & BODYWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATUROPATH
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALDOR
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:520-204-2250
Mailing Address - Street 1:6979 E BROADWAY BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2800
Mailing Address - Country:US
Mailing Address - Phone:520-551-3497
Mailing Address - Fax:520-300-6777
Practice Address - Street 1:6979 E BROADWAY BLVD STE 113
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2800
Practice Address - Country:US
Practice Address - Phone:520-551-3497
Practice Address - Fax:520-300-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-769175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty