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General NPI Number Information
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NPI Number | 1215806922
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Entity Type | Organization
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Legal Business Name | INFINITY SPRINGS SPA, LLC. DBA ETHOS ELEMENTAL WELLNESS SPA
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 1515 GOVERNMENT ST UNIT A201
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3866
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Country | US
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Telephone | 228-238-7198
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 GOVERNMENT ST UNIT A201
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3866
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | TIFFANY ANDERSON
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Credential |
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Telephone | 228-328-7198
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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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