Provider Demographics
NPI:1710146592
Name:ESSENTIAL BODY CARE
Entity Type:Organization
Organization Name:ESSENTIAL BODY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEITKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:970-927-2532
Mailing Address - Street 1:264 CODY LN
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-9106
Mailing Address - Country:US
Mailing Address - Phone:970-927-2532
Mailing Address - Fax:
Practice Address - Street 1:264 CODY LN
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9106
Practice Address - Country:US
Practice Address - Phone:970-927-2532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty