Provider Demographics
NPI:1477327856
Name:IONYX MEDSPA AND WELLNESS CLUB INC
Entity Type:Organization
Organization Name:IONYX MEDSPA AND WELLNESS CLUB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-305-4007
Mailing Address - Street 1:2235 N COURTENAY PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-5227
Mailing Address - Country:US
Mailing Address - Phone:321-305-4007
Mailing Address - Fax:
Practice Address - Street 1:2235 N COURTENAY PKWY STE C
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-5227
Practice Address - Country:US
Practice Address - Phone:321-305-4007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty