Provider Demographics
NPI:1518029438
Name:BENESSERE BODY IN BALANCE
Entity Type:Organization
Organization Name:BENESSERE BODY IN BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:BASHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CNMT
Authorized Official - Phone:612-378-9355
Mailing Address - Street 1:125 MAIN STREET SE
Mailing Address - Street 2:#237
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55433
Mailing Address - Country:US
Mailing Address - Phone:612-378-9355
Mailing Address - Fax:612-378-3046
Practice Address - Street 1:125 MAIN STREET SE
Practice Address - Street 2:#237
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:612-378-9355
Practice Address - Fax:612-378-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty