| NPI | 1790117745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN BAKER Vice President 863-644-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MM31338) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: FL MA68362) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2013-10-28 |