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1598951378
STACY R. SHIDEMANTLE
FORT WALTON BEACH, FL
NPI
1598951378
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: FL MA49802)
Enumeration Date
2007-09-14
Last Update Date
2007-09-14
Business Address
Ms. STACY R. SHIDEMANTLE LMT
301 SUDDUTH CIR NE
FORT WALTON BEACH, FL 32548-5124
Phone number: 850-543-4919
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Mailing Address
Ms. STACY R. SHIDEMANTLE LMT
301 SUDDUTH CIR NE
FORT WALTON BEACH, FL 32548-5124
Phone number: 850-543-4919
Copy
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