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General NPI Number Information
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NPI Number | 1437531761
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Entity Type | Organization
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Legal Business Name | BETTER BODY SPA INC
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 2040 NE 49TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4524
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Country | US
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Telephone | 954-909-9065
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 NE 49TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4524
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Country | US
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Telephone | 954-909-9065
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EVELYN CHAN
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Credential |
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Telephone | 954-909-9065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | MA65852
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License Number State | FL
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