Healthcare Provider Details

I. General information

NPI: 1093965238
Provider Name (Legal Business Name): DEBBIE L HOVATTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6029 E HIGHWAY 98
PANAMA CITY FL
32404-7488
US

IV. Provider business mailing address

6029 E HIGHWAY 98
PANAMA CITY FL
32404-7488
US

V. Phone/Fax

Practice location:
  • Phone: 850-871-3402
  • Fax:
Mailing address:
  • Phone: 850-871-3402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 43634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: