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General NPI Number Information
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NPI Number | 1962835843
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Entity Type | Organization
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Legal Business Name | AXIOS HEALTH SPA, LLC
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 1122 THOMASVILLE RD STE 3
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City | TALLAHASSEE
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State | FL
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Zip | 32303-8702
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Country | US
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Telephone | 407-285-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 TERRACE HOLLOW CT UNIT 1
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City | TALLAHASSEE
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State | FL
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Zip | 32303-5759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHANTELLE YANDOW
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Credential |
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Telephone | 407-285-3354
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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 | 33054
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 41296
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 52193
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License Number State | FL
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