Healthcare Provider Details

I. General information

NPI: 1619787025
Provider Name (Legal Business Name): HINESVILLE DAY SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 GA HIGHWAY 196 W STE B
HINESVILLE GA
31313-4571
US

IV. Provider business mailing address

951 GA HIGHWAY 196 W STE B
HINESVILLE GA
31313-4571
US

V. Phone/Fax

Practice location:
  • Phone: 912-570-9898
  • Fax: 912-877-4030
Mailing address:
  • Phone: 912-570-9898
  • Fax: 912-877-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEELA MARIE EICHHORN
Title or Position: OWNER / CEO
Credential: LMT
Phone: 912-570-9898