Healthcare Provider Details

I. General information

NPI: 1972758712
Provider Name (Legal Business Name): THE TOUCH FACTOR...YOUR BASIC NEED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 FLORIDA AVE STE C
PALM HARBOR FL
34683-4331
US

IV. Provider business mailing address

43 PINEWOOD CIR
SAFETY HARBOR FL
34695-5421
US

V. Phone/Fax

Practice location:
  • Phone: 727-772-1966
  • Fax:
Mailing address:
  • Phone: 813-416-3097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA35086
License Number StateFL

VIII. Authorized Official

Name: HEATHER E MORTENSON
Title or Position: OWNER/PRESIDENT
Credential: LMT
Phone: 813-416-3097