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General NPI Number Information
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NPI Number | 1457275695
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Entity Type | Organization
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Legal Business Name | MYOBALANCE CLINICAL MASSAGE AND MANUAL THERAPY LLC
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 260 N CHERRY ST
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City | MONTICELLO
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State | FL
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Zip | 32344-1925
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Country | US
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Telephone | 448-242-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 260 N CHERRY ST
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City | MONTICELLO
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State | FL
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Zip | 32344-1925
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Country | US
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Telephone | 448-242-4103
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Fax | 850-360-8008
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Authorized Official
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Title or Position | FOUNDER / MANAGING MEMBER
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Name | MS. CHANTAL CALAIS
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Credential | MT
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Telephone | 850-320-1122
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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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