Breath of Life Wellness Spa, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

0019006317 Issued in VA

Legal business name

BREATH OF LIFE WELLNESS SPA, LLC

Practice address

5300 Kempsriver Dr
Suite 106
Virginia Beach, VA 23464-5369

Phone

(757) 390-4136

NPI assigned

Feb 19, 2013

Last updated

Feb 19, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Angela Showers, LMT

Title

Owner

Phone

(757) 390-4136

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1063752657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 KEMPSRIVER DR",
            "address_2": "SUITE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645369",
            "telephone_number": "757-390-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 KEMPSRIVER DR",
            "address_2": "SUITE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645369",
            "telephone_number": "757-390-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATH OF LIFE WELLNESS SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "SHOWERS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-390-4136",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019006317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Massage Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.