Provider Demographics
NPI:1245532647
Name:JUST BREATHE, A WELLNESS SANCTUARY
Entity type:Organization
Organization Name:JUST BREATHE, A WELLNESS SANCTUARY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CARY
Authorized Official - Last Name:MINKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-256-1400
Mailing Address - Street 1:PO BOX 10342
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-0342
Mailing Address - Country:US
Mailing Address - Phone:602-256-1400
Mailing Address - Fax:800-256-7157
Practice Address - Street 1:4203 E INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5359
Practice Address - Country:US
Practice Address - Phone:602-256-1400
Practice Address - Fax:800-256-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-13334173C00000X
1744G0900X
AZMT-09712173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty
No1744G0900XOther Service ProvidersSpecialistGraphics DesignerGroup - Multi-Specialty