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General NPI Number Information
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NPI Number | 1093892432
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Entity Type | Individual
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Provider Name | DONNA LYNN ROWELL L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 615 SW SAINT LUCIE CRES
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City | STUART
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State | FL
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Zip | 34994-2860
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Country | US
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Telephone | 772-781-5444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 331
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City | INDIANTOWN
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State | FL
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Zip | 34956-0331
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Country | US
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Telephone | 772-597-2621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MA19512
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License Number State | FL
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