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General NPI Number Information
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NPI Number | 1144813619
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Entity Type | Organization
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Legal Business Name | BLISS OUT WELLNESS LLC
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 707 NW HILL ST
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City | BEND
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State | OR
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Zip | 97703-2922
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Country | US
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Telephone | 512-850-9178
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Fax |
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Provider Business Mailing Address
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Address Line | 707 NW HILL ST
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City | BEND
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State | OR
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Zip | 97703-2922
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Country | US
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Telephone | 512-850-9178
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | BELINDA MARTINEZ
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Credential | LMT
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Telephone | 512-850-9178
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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 |
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