Healthcare Provider Details

I. General information

NPI: 1730730680
Provider Name (Legal Business Name): SARAH ELIZABETH PETERS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4169 LAMSON AVE
SPRING HILL FL
34608-3707
US

IV. Provider business mailing address

11018 GATLING ST
SPRING HILL FL
34608-2044
US

V. Phone/Fax

Practice location:
  • Phone: 352-596-7887
  • Fax:
Mailing address:
  • Phone: 352-999-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA91957
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: