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General NPI Number Information
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NPI Number | 1699370981
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Entity Type | Organization
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Legal Business Name | BODY RX
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 808 DONAHUE ST
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City | SANTA ROSA
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State | CA
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Zip | 95401-5434
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Country | US
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Telephone | 707-327-8245
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Fax |
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Provider Business Mailing Address
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Address Line | 808 DONAHUE ST
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City | SANTA ROSA
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State | CA
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Zip | 95401-5434
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Country | US
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Telephone | 707-327-8245
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MRS. SONYA MCVAY - STRAUB
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Credential | IMT, ART, NKT, AIM,
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Telephone | 707-327-8245
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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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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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