Healthcare Provider Details

I. General information

NPI: 1245973973
Provider Name (Legal Business Name): ABOVE AND BEYOND SPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3907 HUSSEY RD
GREENWOOD FL
32443-2117
US

IV. Provider business mailing address

3907 HUSSEY RD
GREENWOOD FL
32443-2117
US

V. Phone/Fax

Practice location:
  • Phone: 256-394-0911
  • Fax:
Mailing address:
  • Phone: 256-394-0911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROL L MCGEE
Title or Position: LMT/OWNER
Credential: LMT
Phone: 256-394-0911