Provider Demographics
NPI:1497417406
Name:SUNRISE BODYCARE, LLC
Entity Type:Organization
Organization Name:SUNRISE BODYCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:919-234-1208
Mailing Address - Street 1:1869 LAKE PINE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6043
Mailing Address - Country:US
Mailing Address - Phone:919-234-1208
Mailing Address - Fax:
Practice Address - Street 1:1869 LAKE PINE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6043
Practice Address - Country:US
Practice Address - Phone:919-234-1208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty