Healthcare Provider Details

I. General information

NPI: 1215756085
Provider Name (Legal Business Name): IRELAX.LIFE WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W DUARTE RD STE 209C&D
ARCADIA CA
91007-7617
US

IV. Provider business mailing address

650 W DUARTE RD STE 209C&D
ARCADIA CA
91007-7617
US

V. Phone/Fax

Practice location:
  • Phone: 626-241-2495
  • Fax:
Mailing address:
  • Phone: 626-241-2495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHANGNA XU
Title or Position: DIRECTOR
Credential:
Phone: 626-241-2495