Provider Demographics
NPI:1649627712
Name:K2 BODY SCULPTING LLC
Entity type:Organization
Organization Name:K2 BODY SCULPTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD TRAINER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,BS,ACSM EP-C
Authorized Official - Phone:504-236-9366
Mailing Address - Street 1:1520 N CLAIBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-1340
Mailing Address - Country:US
Mailing Address - Phone:504-236-9366
Mailing Address - Fax:
Practice Address - Street 1:1520 N CLAIBORNE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70116-1340
Practice Address - Country:US
Practice Address - Phone:504-236-9366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Multi-Specialty