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General NPI Number Information
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NPI Number | 1033024138
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Entity Type | Organization
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Legal Business Name | SOUTHERN WELLNESS, LLC
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 1285 J D MILLER RD BLDG A
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-0531
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Country | US
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Telephone | 850-400-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 268 MARQUIS WAY
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City | FREEPORT
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State | FL
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Zip | 32439-4457
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Country | US
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Telephone | 850-400-8441
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Fax |
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Authorized Official
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Title or Position | OWNER AND MANAGER
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Name | MS. AMY DAWN LINDSEY
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Credential |
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Telephone | 850-400-8441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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