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General NPI Number Information
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NPI Number | 1720527989
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Entity Type | Organization
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Legal Business Name | BEAUTY & BODYWORK MASSAGE
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 2535 CAMINO DEL RIO S STE 230
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City | SAN DIEGO
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State | CA
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Zip | 92108-3795
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Country | US
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Telephone | 619-831-8724
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Fax |
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Provider Business Mailing Address
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Address Line | 3103 SWEETWATER SPRINGS BLVD APT 12
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1526
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Country | US
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Telephone | 619-598-4464
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PRECIOUS ANNE AGSAOAY COBARRUBIA
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Credential |
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Telephone | 619-598-4464
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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 | 65400
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License Number State | CA
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