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General NPI Number Information
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NPI Number | 1023362290
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Entity Type | Organization
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Legal Business Name | RELAX URSELF DAY SPA
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 13608 DAPHNE AVE
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City | GARDENA
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State | CA
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Zip | 90249-2353
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Country | US
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Telephone | 310-968-3831
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Fax |
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Provider Business Mailing Address
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Address Line | 11227 S HOBART BLVD STE A
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City | LOS ANGELES
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State | CA
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Zip | 90047-4807
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Country | US
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Telephone |
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Fax | 310-527-7454
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MS. STEPHENIA MARLENE MOTTON
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Credential |
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Telephone | 310-968-3831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | CA
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