Provider Demographics
NPI:1003185323
Name:STRESS REDUCTION SPECIALITIES, LLC
Entity type:Organization
Organization Name:STRESS REDUCTION SPECIALITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOCHUM
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:763-458-3855
Mailing Address - Street 1:11800 ELDORADO ST NW
Mailing Address - Street 2:108
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2401
Mailing Address - Country:US
Mailing Address - Phone:763-458-3855
Mailing Address - Fax:
Practice Address - Street 1:527 COON RAPIDS BLVD NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5520
Practice Address - Country:US
Practice Address - Phone:736-458-3855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty