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General NPI Number Information
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NPI Number | 1063940591
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Entity Type | Organization
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Legal Business Name | REBJAS LLC
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Dates
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Enumeration Date | 05/29/2017
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 32347 COUNTY ROAD 473
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City | LEESBURG
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State | FL
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Zip | 34788-8801
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Country | US
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Telephone | 352-308-8941
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Fax |
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Provider Business Mailing Address
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Address Line | 33215 COVENTRY DR
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City | LEESBURG
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State | FL
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Zip | 34788-3614
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Country | US
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Telephone | 407-252-2646
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Fax |
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Authorized Official
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Title or Position | OWNER/LMT
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Name | REBECCA NOLL
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Credential | LMT
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Telephone | 352-308-8941
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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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