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General NPI Number Information
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NPI Number | 1548758535
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Entity Type | Organization
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Legal Business Name | JUNIPER SPA & YOGA STUDIO LLC
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 145 S 56TH ST STE A
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City | LINCOLN
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State | NE
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Zip | 68510-2100
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Country | US
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Telephone | 402-488-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 145 S 56TH ST STE A
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City | LINCOLN
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State | NE
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Zip | 68510-2100
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Country | US
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Telephone | 402-488-0026
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Fax |
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Authorized Official
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Title or Position | OWNER/LMT
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Name | MICHELLE RIEFLIN
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Credential | LMT
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Telephone | 402-488-0026
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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 | 2220
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License Number State | NE
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