Healthcare Provider Details

I. General information

NPI: 1851617476
Provider Name (Legal Business Name): PATSY WHITT SAUNDERS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 W MIDWAY RD
FORT PIERCE FL
34982-4203
US

IV. Provider business mailing address

776 W MIDWAY RD
FORT PIERCE FL
34982-4203
US

V. Phone/Fax

Practice location:
  • Phone: 772-460-7999
  • Fax: 772-460-7995
Mailing address:
  • Phone: 772-460-7999
  • Fax: 772-460-7995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA9894
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: