Organization
PURE BODYWORK
Active
Other names
Pure Bodywork
Organization subpart
No
Provider details
NPI number
Authorized official
SOUTHIDA HOWARD (PROPRIETOR)
(310) 396-6800
Entity
Organization
Contact information
Practice address
2905 STANFORD AVE, MARINA DEL REY, CA 90292-5524
(310) 396-6800
Mailing address
PO BOX 11072, MARINA DEL REY, CA 90295-7072
(310) 849-7799
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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