Provider Demographics
NPI:1982934279
Name:MOSAIC INC
Entity Type:Organization
Organization Name:MOSAIC INC
Other - Org Name:MOSAIC SALONSPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC/TREAS
Authorized Official - Prefix:
Authorized Official - First Name:TAHLEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:AITCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-536-1700
Mailing Address - Street 1:1328 S SOUTHEAST BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2570
Mailing Address - Country:US
Mailing Address - Phone:509-536-1700
Mailing Address - Fax:
Practice Address - Street 1:1328 S SOUTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2570
Practice Address - Country:US
Practice Address - Phone:509-536-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty