Provider Demographics
NPI:1710604855
Name:FCBODYWORKS LLC
Entity Type:Organization
Organization Name:FCBODYWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:THAYN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:435-668-1765
Mailing Address - Street 1:PO BOX 1266
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84771-1266
Mailing Address - Country:US
Mailing Address - Phone:435-668-1765
Mailing Address - Fax:
Practice Address - Street 1:237 N BLUFF ST
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4543
Practice Address - Country:US
Practice Address - Phone:435-669-8992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty