Provider Demographics
NPI:1700181526
Name:QUEEN BEE FITNESS AND WELLNESS
Entity Type:Organization
Organization Name:QUEEN BEE FITNESS AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOUSOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-413-8650
Mailing Address - Street 1:664A NANTASKET AVE
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-2148
Mailing Address - Country:US
Mailing Address - Phone:781-925-5600
Mailing Address - Fax:
Practice Address - Street 1:664A NANTASKET AVE
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045-2148
Practice Address - Country:US
Practice Address - Phone:781-925-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty