Provider Demographics
NPI:1063953925
Name:UNIQUE FITNESS
Entity type:Organization
Organization Name:UNIQUE FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTHOF
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMT
Authorized Official - Phone:402-822-2561
Mailing Address - Street 1:263 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-2122
Mailing Address - Country:US
Mailing Address - Phone:401-615-2355
Mailing Address - Fax:
Practice Address - Street 1:263 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-2122
Practice Address - Country:US
Practice Address - Phone:401-615-2355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-12
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMT02245225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty