Wolf Pack LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WOLF PACK LLC

Doing business as

Ahhhsome Relaxation

Practice address

939 S 25TH E Ste 115
Ammon, ID 83406-5736

Phone

(208) 523-1209

NPI assigned

Jul 13, 2020

Organization subpart

No

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

Authorized official

Name

Shawn Tolman

Title

Ceo

Phone

(208) 313-1089

Specialties & licenses 1

Addresses

Other names 1

• Ahhhsome Relaxation Doing business as

Locations

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1992323216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 S 25TH E STE 115",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065736",
            "telephone_number": "208-523-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 S 25TH E STE 115",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065736",
            "telephone_number": "208-523-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF PACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "TOLMAN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-313-1089"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ahhhsome Relaxation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Eder MD (PSC Radiate)
• Levi Peterson Williams, DPT, PT
• Mariah Williams
• Phillip Everett Willis
• Lisa Wilmore
• Shing Tin Wong
• Chanelle Woodland, BA
• Ashlee Woodward, LMSW
• Krystalrose Worthington, LCPC
• Emily Wrathall

• Clinic/Center in Ammon, ID
• Providers in Ammon, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.