Slender Spa Med Enterprises, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SLENDER SPA MED ENTERPRISES, LLC

Practice address

1475 Holcomb Bridge Rd
Suite 165
Roswell, GA 30076-2139

Phone

(678) 682-8600

NPI assigned

Sep 18, 2012

Last updated

Jan 15, 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. Tanya Grizzle

Title

Owner

Phone

(678) 682-8600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1245580174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 165",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762139",
            "telephone_number": "678-682-8600",
            "fax_number": "678-682-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 165",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762139",
            "telephone_number": "678-682-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLENDER SPA MED ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-18",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "GRIZZLE",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-682-8600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Roswell, GA
• Providers in Roswell, GA by specialty
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.