Provider Demographics
NPI:1396160693
Name:BIO FOOT REFLEXOLOGY AND MASSAGE CENTER LLC
Entity type:Organization
Organization Name:BIO FOOT REFLEXOLOGY AND MASSAGE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:LEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-572-2250
Mailing Address - Street 1:17777 LOWER BOONES FERRY RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5398
Mailing Address - Country:US
Mailing Address - Phone:503-699-5888
Mailing Address - Fax:
Practice Address - Street 1:17777 LOWER BOONES FERRY RD STE A
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5398
Practice Address - Country:US
Practice Address - Phone:503-699-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIO FOOT REFLEXOLOGY AND MASSAGE CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-23
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty