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General NPI Number Information
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NPI Number | 1104044866
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Entity Type | Organization
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Legal Business Name | WELLINGTON'S PREMIER DAY SPA
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9116 FOREST HILL BLVD
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City | WELLINGTON
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State | FL
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Zip | 33411-6564
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Country | US
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Telephone | 561-804-1111
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Fax | 561-804-1112
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Provider Business Mailing Address
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Address Line | 9116 FOREST HILL BLVD
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City | WELLINGTON
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State | FL
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Zip | 33411-6564
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Country | US
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Telephone | 561-804-1111
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Fax | 561-804-1112
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Authorized Official
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Title or Position | OWNER
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Name | MS. BAILEY KRISTEN HASTINGS
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Credential |
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Telephone | 561-804-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | FL
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