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General NPI Number Information
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NPI Number | 1154598555
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Entity Type | Organization
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Legal Business Name | MISSION HEALTH & MASSAGE INC.
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 06/11/2014
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Provider Practice Location Address
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Address Line | 930 MARCUM ROAD SUITE 5
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City | LAKELAND
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State | FL
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Zip | 33809
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Country | US
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Telephone | 863-853-8877
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Fax |
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Provider Business Mailing Address
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Address Line | 5342 US HIGHWAY 98 N
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City | LAKELAND
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State | FL
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Zip | 33809-0517
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Country | US
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Telephone | 863-853-8877
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | H JANET HARPER
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Credential | LMT
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Telephone | 863-853-8877
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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 | MM14061
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License Number State | FL
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