Provider Demographics
NPI:1285888545
Name:CARPE DIEM, MASSAGE AND SKIN
Entity type:Organization
Organization Name:CARPE DIEM, MASSAGE AND SKIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CMT
Authorized Official - Prefix:
Authorized Official - First Name:LARAE
Authorized Official - Middle Name:
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:707-763-1526
Mailing Address - Street 1:35 MARIA DR
Mailing Address - Street 2:SUITE 850
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-3548
Mailing Address - Country:US
Mailing Address - Phone:707-763-1526
Mailing Address - Fax:
Practice Address - Street 1:35 MARIA DR
Practice Address - Street 2:SUITE 850
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3548
Practice Address - Country:US
Practice Address - Phone:707-763-1526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Single Specialty