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General NPI Number Information
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NPI Number | 1427616150
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Entity Type | Individual
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Provider Name | CLARISSA PIERCE LMT, RT(T)
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Gender | Female
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 10139 NW 31ST ST STE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3908
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Country | US
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Telephone | 954-755-1292
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Fax |
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Provider Business Mailing Address
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Address Line | 4688 CORAL RIDGE DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-2252
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Country | US
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Telephone | 754-214-0802
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | MA-57930
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | CRT-91914
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA-57930
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License Number State | FL
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