Provider Demographics
NPI:1780040030
Name:REAM ENTERPRISES LLC
Entity Type:Organization
Organization Name:REAM ENTERPRISES LLC
Other - Org Name:WINDPEAK SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:REAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-207-0694
Mailing Address - Street 1:1102 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-2820
Mailing Address - Country:US
Mailing Address - Phone:850-207-0694
Mailing Address - Fax:
Practice Address - Street 1:401 W 14TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3789
Practice Address - Country:US
Practice Address - Phone:850-866-4456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-01
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA70788225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty