MEDICARE: HIVE BODY DYNAMICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1043143431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIVE BODY DYNAMICS LLC

Provider Business Mailing Address
First Line	:	3900 OLDFIELD CROSSING DR APT 1119
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-7881
Country	:	US
Telephone Number	:	503-719-0981
Fax Number	:	904-559-2834

Provider Business Practice Location Address
First Line	:	1628 SAN MARCO BLVD STE 14
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-3074
Country	:	US
Telephone Number	:	503-719-0981
Fax Number	:	904-559-2834

Authorized Official
Title or Position	:	OWNER
Name	:	MS. IZABELLE LAWSTON
Credential	:	LMT
Telephone Number	:	503-719-0981

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “HIVE BODY DYNAMICS LLC ” Practice Location

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