Provider Demographics
NPI:1922337997
Name:INFINITY BODY DREAM WORKS INC DBA INFINITY HEALING CTR
Entity Type:Organization
Organization Name:INFINITY BODY DREAM WORKS INC DBA INFINITY HEALING CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-289-8598
Mailing Address - Street 1:416 W LAS TUNAS DR
Mailing Address - Street 2:STE 201
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1236
Mailing Address - Country:US
Mailing Address - Phone:626-289-8598
Mailing Address - Fax:626-289-8278
Practice Address - Street 1:416 W LAS TUNAS DR
Practice Address - Street 2:STE 201
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1236
Practice Address - Country:US
Practice Address - Phone:626-289-8598
Practice Address - Fax:626-289-8278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty