Healthcare Provider Details

I. General information

NPI: 1699683953
Provider Name (Legal Business Name): EVEXIA THERAPEUTIC MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 PENN AVE S STE 500K
BLOOMINGTON MN
55431-1367
US

IV. Provider business mailing address

8120 PENN AVE S STE 500K
BLOOMINGTON MN
55431-1367
US

V. Phone/Fax

Practice location:
  • Phone: 952-856-0336
  • 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: JESSICA D CARDWELL
Title or Position: OWNDER
Credential: BCTMB
Phone: 952-856-0336