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General NPI Number Information
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NPI Number | 1144472184
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Entity Type | Individual
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Provider Name | SUSAN KELLY SCHINSTINE
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Gender | Female
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 151 MARY ESTHER BLVD STE 309B
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City | MARY ESTHER
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State | FL
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Zip | 32569-1974
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Country | US
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Telephone | 859-582-6674
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Fax | 850-939-5221
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Provider Business Mailing Address
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Address Line | 2259 PALOMA ST
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City | NAVARRE
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State | FL
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Zip | 32566-1216
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Country | US
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Telephone | 850-582-6674
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Fax | 850-939-5221
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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 | MA 28934
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License Number State | FL
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