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General NPI Number Information
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NPI Number | 1457374894
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Entity Type | Individual
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Provider Name | PETE PFANNERSTILL PH.D., LMT, CKTI
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 02/17/2018
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Provider Practice Location Address
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Address Line | 1936 W DR MARTIN LUTHER KING JR BLVD SUITE 103
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City | TAMPA
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State | FL
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Zip | 33607-6500
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Country | US
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Telephone | 813-875-5872
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Fax | 813-870-2324
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Provider Business Mailing Address
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Address Line | 1936 W DR MARTIN LUTHER KING JR BLVD STE 103
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City | TAMPA
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State | FL
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Zip | 33607-6530
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Country | US
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Telephone | 813-482-7200
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA24089
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License Number State | FL
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