Healthcare Provider Details

I. General information

NPI: 1548199987
Provider Name (Legal Business Name): A-SPA13
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 BOXWOOD BLVD
COLUMBUS GA
31906-2706
US

IV. Provider business mailing address

2050 WARM SPRINGS RD
COLUMBUS GA
31904-7958
US

V. Phone/Fax

Practice location:
  • Phone: 706-718-4173
  • Fax:
Mailing address:
  • Phone:
  • 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: EDDIE ROY EDWARDS
Title or Position: OWNER
Credential:
Phone: 706-718-4173