Provider Demographics
NPI:1679816904
Name:UNLOCKING THE BODY ENTERPRISES, PLLC
Entity Type:Organization
Organization Name:UNLOCKING THE BODY ENTERPRISES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-970-8256
Mailing Address - Street 1:11921 CANYON RD E
Mailing Address - Street 2:SUITE A
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-4403
Mailing Address - Country:US
Mailing Address - Phone:253-970-8256
Mailing Address - Fax:253-604-4450
Practice Address - Street 1:11921 CANYON RD E
Practice Address - Street 2:SUITE A
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-4403
Practice Address - Country:US
Practice Address - Phone:253-970-8256
Practice Address - Fax:253-604-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty