Provider Demographics
NPI:1841544780
Name:HUMAN BODY WORKS, LLC
Entity type:Organization
Organization Name:HUMAN BODY WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRY
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-402-6776
Mailing Address - Street 1:4510 INTELCO LOOP SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-6004
Mailing Address - Country:US
Mailing Address - Phone:360-402-6776
Mailing Address - Fax:360-347-1850
Practice Address - Street 1:4510 INTELCO LOOP SE
Practice Address - Street 2:SUITE A
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-6004
Practice Address - Country:US
Practice Address - Phone:360-402-6776
Practice Address - Fax:360-347-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012268225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty