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General NPI Number Information
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NPI Number | 1083261564
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Entity Type | Organization
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Legal Business Name | QI THERAPY INC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 2741 EXECUTIVE PARK DR STE 4
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City | WESTON
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State | FL
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Zip | 33331-3641
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Country | US
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Telephone | 954-380-2263
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Fax |
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Provider Business Mailing Address
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Address Line | 2908 NW 80TH AVE 2908
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City | SUNRISE
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State | FL
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Zip | 33322
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Country | US
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Telephone | 954-380-2263
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | PAOLA ANDREA MAZO
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Credential | LMT
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Telephone | 954-380-2263
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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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