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General NPI Number Information
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NPI Number | 1487878666
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Entity Type | Individual
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Provider Name | PETRINA MARIE WINDSOR LMT
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 410 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32501-3919
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Country | US
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Telephone | 850-293-4204
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Fax | 850-458-1253
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Provider Business Mailing Address
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Address Line | 6501 LILLIAN HWY
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City | PENSACOLA
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State | FL
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Zip | 32506-3947
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Country | US
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Telephone | 850-293-4204
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Fax | 850-458-1253
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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 | MA37462
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License Number State | FL
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