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General NPI Number Information
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NPI Number | 1114799806
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Entity Type | Organization
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Legal Business Name | VAYLA WELLNESS, LLC
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 4909 E HIGHWAY 22
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City | PANAMA CITY
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State | FL
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Zip | 32404-6233
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Country | US
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Telephone | 850-358-8535
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Fax |
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Provider Business Mailing Address
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Address Line | 4909 E HIGHWAY 22
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City | PANAMA CITY
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State | FL
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Zip | 32404-6233
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Country | US
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Telephone | 850-358-8535
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PHUONG THANH THI NGUYEN
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Credential |
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Telephone | 850-358-8535
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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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