| NPI | 1922279041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POUNGSRI VONBERNUTH Owner / Therapist 813-685-2315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL MM11331) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA13798) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-06-16 |