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General NPI Number Information
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NPI Number | 1356767024
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Entity Type | Organization
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Legal Business Name | COMFORT ZONE MASSAGE LLC
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 206 HOWARD ST
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City | AUBURNDALE
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State | FL
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Zip | 33823-3435
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Country | US
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Telephone | 863-967-1980
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Fax | 863-967-1161
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Provider Business Mailing Address
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Address Line | 206 HOWARD ST
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City | AUBURNDALE
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State | FL
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Zip | 33823-3435
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Country | US
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Telephone | 863-967-1980
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Fax | 863-967-1161
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Authorized Official
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Title or Position | OWNER
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Name | LINDA C WALKER
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Credential | LMT
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Telephone | 863-967-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MM14502
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License Number State | FL
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