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General NPI Number Information
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NPI Number | 1174890602
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Entity Type | Individual
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Provider Name | AMY MANUEL L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 3126 SW MARTIN DOWNS BLVD
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City | PALM CITY
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State | FL
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Zip | 34990-2641
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Country | US
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Telephone | 772-485-4675
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Fax | 772-288-3756
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Provider Business Mailing Address
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Address Line | PO BOX 2305
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City | PALM CITY
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State | FL
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Zip | 34991-7305
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Country | US
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Telephone | 772-485-4675
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Fax | 772-288-3756
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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 | MA63185
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License Number State | FL
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