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NPI Code Detail

MEDICARE: FABRIC SPA, LLC

MEDICARE: FABRIC SPA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAK001210PA
2171100000XAcupuncturistAK000670PA
3225700000XMassage TherapistMSG008665PA
4225700000XMassage TherapistMSG004229PA
5225700000XMassage TherapistMSG007572PA
6225700000XMassage TherapistMSG011032PA
7171100000XAcupuncturistAK001056PA

General Provider Information

NPI Number : 1295261477
Entity Type Code : Organization
Provider Name (Legal Business Name) : FABRIC SPA, LLC
Provider Business Mailing Address
First Line : 728 S 4TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-3120
Country : US
Telephone Number : 215-922-3235
Fax Number :
Provider Business Practice Location Address
First Line : 728 S 4TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-3120
Country : US
Telephone Number : 215-922-3235
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. GABRIELLE MELISSA APPLEBAUM
Credential : L.AC.,M.AC.,DIPL.AC.
Telephone Number : 215-922-3235
Provider Enumeration Date : 05/05/2017
Last Update Date : 05/05/2017

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Directions to “FABRIC SPA, LLC ” Practice Location

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