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General NPI Number Information
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NPI Number | 1053067546
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Entity Type | Organization
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Legal Business Name | FLYING 3SIXTY NAX, INC.
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 432 BEACH 47TH ST APT 2
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1119
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Country | US
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Telephone | 718-688-5154
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Fax | 347-619-5538
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Provider Business Mailing Address
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Address Line | 432 BEACH 47TH ST APT 2
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1119
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Country | US
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Telephone | 718-688-5154
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Fax | 347-619-5538
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | NATASHA CARTER
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Credential |
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Telephone | 718-688-5154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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