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General NPI Number Information
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NPI Number | 1891972725
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Entity Type | Organization
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Legal Business Name | FALLING WATERS HEALING SPA, INC.
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1885 S ARLINGTON AVE SUITE 108
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City | RENO
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State | NV
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Zip | 89509-3310
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Country | US
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Telephone | 775-329-2888
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Fax | 775-329-2971
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Provider Business Mailing Address
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Address Line | 1885 S ARLINGTON AVE SUITE 108
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City | RENO
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State | NV
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Zip | 89509-3310
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Country | US
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Telephone | 775-329-2888
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Fax | 775-329-2971
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DIANE LUND SHAW
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Credential |
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Telephone | 775-329-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B293
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License Number State | NV
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