MEDICARE: BODY PHILOSOPHY SPA

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	BU21332030	CA

General Provider Information

NPI Number	:	1912380924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY PHILOSOPHY SPA

Provider Business Mailing Address
First Line	:	1729 TERMINO AVE
Second Line	:	B
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2121
Country	:	US
Telephone Number	:	562-472-1579
Fax Number	:

Provider Business Practice Location Address
First Line	:	1729 TERMINO AVE
Second Line	:	B
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2121
Country	:	US
Telephone Number	:	562-472-1579
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEBBIE OBARSKI
Credential	:
Telephone Number	:	562-472-1579

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	07/08/2015

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Directions to “BODY PHILOSOPHY SPA ” Practice Location

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