Provider Demographics
NPI:1972978104
Name:FIVE BODIES COLLECTIVE LLC
Entity type:Organization
Organization Name:FIVE BODIES COLLECTIVE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOCUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURMESTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-344-4788
Mailing Address - Street 1:PO BOX 40771
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-0133
Mailing Address - Country:US
Mailing Address - Phone:541-344-4788
Mailing Address - Fax:877-699-5228
Practice Address - Street 1:2485 W 7TH PL STE 1
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2687
Practice Address - Country:US
Practice Address - Phone:541-344-4788
Practice Address - Fax:877-699-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty