Healthcare Provider Details

I. General information

NPI: 1922501659
Provider Name (Legal Business Name): INNER OCEANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2018
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 2ND ST STE 44B
SANTA FE NM
87505-3519
US

IV. Provider business mailing address

1807 2ND ST STE 44B
SANTA FE NM
87505-3519
US

V. Phone/Fax

Practice location:
  • Phone: 505-670-7780
  • 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: JULIE E STRASSBURGER
Title or Position: OWNER
Credential: CLT, LMT
Phone: 505-670-7780