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General NPI Number Information
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NPI Number | 1336529023
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Entity Type | Individual
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Provider Name | JOHN KATO JR.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 516 S 10TH ST
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-3530
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Country | US
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Telephone | 904-237-5205
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Fax |
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Provider Business Mailing Address
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Address Line | 473951 MIDDLE RD
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City | HILLIARD
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State | FL
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Zip | 32046-6205
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Country | US
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Telephone | 904-237-5205
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Fax |
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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 | MA77392
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License Number State | FL
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