Provider Demographics
NPI:1427421445
Name:UNIQUE BODYWORKS LLC
Entity type:Organization
Organization Name:UNIQUE BODYWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:IGOREVNA
Authorized Official - Last Name:GUREVICH-PECK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-673-8276
Mailing Address - Street 1:2176 LAUWILIWILI ST UNIT OFFICE38
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1881
Mailing Address - Country:US
Mailing Address - Phone:808-673-8276
Mailing Address - Fax:866-477-1504
Practice Address - Street 1:2176 LAUWILIWILI ST UNIT OFFICE38
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1881
Practice Address - Country:US
Practice Address - Phone:808-673-8276
Practice Address - Fax:866-477-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-11861174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty