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General NPI Number Information
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NPI Number | 1437471034
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Entity Type | Organization
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Legal Business Name | REJUVENATE MASSAGE AND WELLNESS
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Dates
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Enumeration Date | 02/23/2010
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 6943 STIRLING RD
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City | DAVIE
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State | FL
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Zip | 33314-7113
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Country | US
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Telephone | 954-581-8727
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Fax |
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Provider Business Mailing Address
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Address Line | 6943 STIRLING RD
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City | DAVIE
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State | FL
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Zip | 33314-7113
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Country | US
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Telephone | 954-581-8727
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHERINE VENTURA
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Credential |
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Telephone | 954-581-8727
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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 | MM22788
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License Number State | FL
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