Provider Demographics
NPI:1194410621
Name:ESSENTIAL WELLNESS BODYWORK AND MASSAGE
Entity type:Organization
Organization Name:ESSENTIAL WELLNESS BODYWORK AND MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD RECEPTION
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-441-8625
Mailing Address - Street 1:PO BOX 1276
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97528-0104
Mailing Address - Country:US
Mailing Address - Phone:541-916-8585
Mailing Address - Fax:541-226-2163
Practice Address - Street 1:849 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1634
Practice Address - Country:US
Practice Address - Phone:541-916-8585
Practice Address - Fax:541-226-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty