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General NPI Number Information
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NPI Number | 1487384830
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Entity Type | Individual
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Provider Name | PATRICIA ANN WINBLAD LMT
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Gender | Female
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 130 W WENGER RD
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City | ENGLEWOOD
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State | OH
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Zip | 45322-2760
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Country | US
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Telephone | 937-242-2529
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 MYSTIC LN S
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City | TROY
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State | OH
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Zip | 45373-1822
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Country | US
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Telephone | 937-242-2529
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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 | 33.022517
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License Number State | OH
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