Organization
FITNESS RECOVERY ROOM LLC
Active
Other names
Hawks Prairie Massage Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIL ELLINGER LMP (OWNER/REGISTERED AGENT)
(360) 951-4893
Entity
Organization
Contact information
Practice address
8830 TALLON LN NE, F, LACEY, WA 98516-6656
(360) 819-2877
Mailing address
8830 TALLON LN NE, F, LACEY, WA 98516-6656
(360) 819-2877
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
603440613
WA
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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