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General NPI Number Information
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NPI Number | 1457168247
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Entity Type | Organization
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Legal Business Name | SARASOTA THERAPEUTIC MASSAGE
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 5632 BEE RIDGE RD STE 101
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City | SARASOTA
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State | FL
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Zip | 34233-1506
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Country | US
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Telephone | 941-378-9959
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Fax |
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Provider Business Mailing Address
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Address Line | 4863 PASTEL CT
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City | SARASOTA
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State | FL
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Zip | 34240-2529
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Country | US
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Telephone | 614-315-6115
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | MICHELLE WOLF
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Credential | LMT
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Telephone | 614-315-6115
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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 |
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License Number State |
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