Provider Demographics
NPI:1316103203
Name:SPA SOLUTIONS
Entity type:Organization
Organization Name:SPA SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:WARDELL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-294-8111
Mailing Address - Street 1:3307 GRAND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6546
Mailing Address - Country:US
Mailing Address - Phone:406-294-8111
Mailing Address - Fax:406-294-6701
Practice Address - Street 1:3307 GRAND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6546
Practice Address - Country:US
Practice Address - Phone:406-294-8111
Practice Address - Fax:406-294-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty