{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "SPOILED ENERGY AND DAY SPA INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"FirstLineMailingAddress": "PO BOX 171",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIVERSIDE",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84334-0171",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "435-237-9093",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "805 W MAIN ST STE E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TREMONTON",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84337-2608",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "435-257-5367",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/11/2022",
"LastUpdateDate": "01/11/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POEN",
"AuthorizedOfficialFirstName": "AMY",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
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"AuthorizedOfficialCredential": "LMT, BCTMB",
"AuthorizedOfficialTelephoneNumber": "435-237-9093",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}