Provider Demographics
NPI:1124835822
Name:WHOLE HEALTH BODYWORK
Entity type:Organization
Organization Name:WHOLE HEALTH BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:610-425-7482
Mailing Address - Street 1:225 LAND GRANT ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-1693
Mailing Address - Country:US
Mailing Address - Phone:904-297-8387
Mailing Address - Fax:
Practice Address - Street 1:225 LAND GRANT ST UNIT 2
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-1693
Practice Address - Country:US
Practice Address - Phone:610-425-7482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty