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General NPI Number Information
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NPI Number | 1326287640
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Entity Type | Individual
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Provider Name | JACQUELINE ANN BUDDINGH LMT
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Gender | Female
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 611 S PROSPECT AVE 611 PROSPECT AVE S
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City | CLEARWATER
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State | FL
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Zip | 33756-5627
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Country | US
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Telephone | 727-461-2500
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Fax | 727-461-2500
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Provider Business Mailing Address
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Address Line | PO BOX 5767
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City | CLEARWATER
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State | FL
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Zip | 33758-5767
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Country | US
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Telephone | 727-461-2500
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Fax | 727-461-2500
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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 | MA34537
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License Number State | FL
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