Provider Demographics
NPI:1871815951
Name:BOBEN, LLC
Entity Type:Organization
Organization Name:BOBEN, LLC
Other - Org Name:MASSAGEFIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR/BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-737-8552
Mailing Address - Street 1:3864 SAN JOSE PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4613
Mailing Address - Country:US
Mailing Address - Phone:904-737-8552
Mailing Address - Fax:904-737-8113
Practice Address - Street 1:3864 SAN JOSE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4613
Practice Address - Country:US
Practice Address - Phone:904-737-8552
Practice Address - Fax:904-737-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4435111N00000X
FLAP2591171100000X
FLMA24586225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty