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General NPI Number Information
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NPI Number | 1467901140
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Entity Type | Organization
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Legal Business Name | MASSAGE THERAPY BY DEBI LLC
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 5632 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34233-1556
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Country | US
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Telephone | 941-232-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 5632 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34233-1556
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Country | US
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Telephone | 941-232-4673
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEBRA MARIE MACLOUD
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Credential | LMT
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Telephone | 941-232-4673
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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 | MA44093
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License Number State | FL
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