Provider Demographics
NPI:1710236278
Name:AFFUSIONS THERAPEUTIC BODY SPA
Entity Type:Organization
Organization Name:AFFUSIONS THERAPEUTIC BODY SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:678-519-5185
Mailing Address - Street 1:6740 SHANNON PKWY
Mailing Address - Street 2:STE.9
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-2057
Mailing Address - Country:US
Mailing Address - Phone:678-519-5185
Mailing Address - Fax:
Practice Address - Street 1:6740 SHANNON PKWY
Practice Address - Street 2:STE.9
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-2057
Practice Address - Country:US
Practice Address - Phone:678-519-5185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty