Provider Demographics
NPI:1720329303
Name:ONE BODY MASSAGE & RESTORATION LLC
Entity type:Organization
Organization Name:ONE BODY MASSAGE & RESTORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-223-0001
Mailing Address - Street 1:1106 HARRIS AVE.
Mailing Address - Street 2:#312
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-223-0001
Mailing Address - Fax:
Practice Address - Street 1:1106 HARRIS AVE.
Practice Address - Street 2:#312
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-223-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60173639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty