Provider Demographics
NPI:1144805185
Name:BODY HARMONY CORRECTIVE MASSAGE AND SPA
Entity type:Organization
Organization Name:BODY HARMONY CORRECTIVE MASSAGE AND SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CANEN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:817-690-9967
Mailing Address - Street 1:3605 MOCKINGBIRD CIR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-7853
Mailing Address - Country:US
Mailing Address - Phone:817-690-9967
Mailing Address - Fax:
Practice Address - Street 1:821 SW ALSBURY BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4090
Practice Address - Country:US
Practice Address - Phone:682-207-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty