| NPI | 1184810160 |
|---|---|
| Doing Business As | BACK IN SHAPE MASSAGE THERAPY |
| Entity Type | Organization |
| Authorized Contact | JAMIE LYNN KONIDARE President 561-844-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC7029) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |