Provider Demographics
NPI:1851153589
Name:INSATIABLE MASSAGE & BEAUTY SVC LLC SERVICES
Entity Type:Organization
Organization Name:INSATIABLE MASSAGE & BEAUTY SVC LLC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NADYA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LMR
Authorized Official - Phone:909-771-0751
Mailing Address - Street 1:30 N GOULD ST STE R
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6317
Mailing Address - Country:US
Mailing Address - Phone:307-381-1922
Mailing Address - Fax:
Practice Address - Street 1:267 N TERRACE ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-1429
Practice Address - Country:US
Practice Address - Phone:909-771-0751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty