Provider Demographics
NPI:1578108262
Name:INFINITY MASSAGE AND BODYWORK
Entity Type:Organization
Organization Name:INFINITY MASSAGE AND BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNODIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-749-0975
Mailing Address - Street 1:4028 S HOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-4408
Mailing Address - Country:US
Mailing Address - Phone:414-599-7992
Mailing Address - Fax:
Practice Address - Street 1:4028 S HOWELL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-4408
Practice Address - Country:US
Practice Address - Phone:414-559-7992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-17
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty