Provider Demographics
NPI:1831673318
Name:BIOS MEDICAL MASSAGE LLC
Entity Type:Organization
Organization Name:BIOS MEDICAL MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:850-225-1815
Mailing Address - Street 1:29 HALLELUJAH AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-6085
Mailing Address - Country:US
Mailing Address - Phone:850-225-1815
Mailing Address - Fax:
Practice Address - Street 1:29 HALLELUJAH AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-6085
Practice Address - Country:US
Practice Address - Phone:850-225-1815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty