Provider Demographics
NPI:1912380924
Name:BODY PHILOSOPHY SPA
Entity Type:Organization
Organization Name:BODY PHILOSOPHY SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-472-1579
Mailing Address - Street 1:1729 TERMINO AVE
Mailing Address - Street 2:B
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2121
Mailing Address - Country:US
Mailing Address - Phone:562-472-1579
Mailing Address - Fax:
Practice Address - Street 1:1729 TERMINO AVE
Practice Address - Street 2:B
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2121
Practice Address - Country:US
Practice Address - Phone:562-472-1579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABU21332030225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty