Provider Demographics
NPI:1558996405
Name:I ADORE HER BODY SPA LLC
Entity Type:Organization
Organization Name:I ADORE HER BODY SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMEERAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-433-6333
Mailing Address - Street 1:3817 GOODELL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1241
Mailing Address - Country:US
Mailing Address - Phone:804-433-6333
Mailing Address - Fax:
Practice Address - Street 1:827 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1126
Practice Address - Country:US
Practice Address - Phone:804-433-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service