Healthcare Provider Details

I. General information

NPI: 1407022577
Provider Name (Legal Business Name): MARCY ANN YARBOROUGH LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 FRUITVILLE RD
SARASOTA FL
34240-8957
US

IV. Provider business mailing address

6750 BRENTFORD RD
SARASOTA FL
34241-5705
US

V. Phone/Fax

Practice location:
  • Phone: 941-376-3342
  • Fax:
Mailing address:
  • Phone: 941-376-3342
  • Fax: 941-371-8543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA27733
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberMA 27733
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: