Provider Demographics
NPI:1841061389
Name:SANTA FE BODYWORK, LLC
Entity type:Organization
Organization Name:SANTA FE BODYWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHELANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:STANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-310-3785
Mailing Address - Street 1:PO BOX 24224
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-9224
Mailing Address - Country:US
Mailing Address - Phone:505-310-3785
Mailing Address - Fax:
Practice Address - Street 1:4101 SOARING EAGLE LN
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-0818
Practice Address - Country:US
Practice Address - Phone:505-310-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty